HomeMy WebLinkAbout170 Kensington Dr - Permits/New Commercial - 06/29/1984a_.; .rvsy ,... l;c'� s. - , t :� 'l. �� - ,- �y?.�4`� •C F1. -.r yr _ ---C - .1-r , .. - �
amity by -ort C,oIl1I1S BUILDING INSPECTION DIVISION 4
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address,
Name r i f% r a: s i �-:r.. r%, Ado 71
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Mail Address
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Name } '✓ 4� 4
Address �
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License No.
Phone' f s z
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Lot
Block
Filing Number
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Subdivision
°
P U D
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DESCRIPTION OF WORK
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Stock Options
Plan No. Codes
Est. Total Cost
(including labor, material, profit) '
I hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
__-_-
signed '- _—_- date,
— CLASS OF -WORK —
New Alteration Addition Demolish Move
O: ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑' G., ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area ^ ; 2 9
Height
No. Stories �..
Lot Area'..„r, ;
` s
Frovtntage
Occ. load
Occ. Change from
Plat File No.
No. D.U. -----
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review r
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
- r
City Sales Tax
z-F-0—
St. Oversizing
_
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
,Total Fees,
Off -Street Parking
(No. Cars)
Interior Lot
❑
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a;
Corner Lot
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Reversed Corner
Lot ❑
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Street,:
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ZBA Case #
Date
BBA Case #
Date
Building Insp. a
Approval
by f. ;,
date
Permit No.
Date .,
Distribution: Original - ApplfcanllBlue-Office Canary'- Sales Tax: Pine Applicant: Tag - Bldg. In,sp. ti
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