HomeMy WebLinkAbout1824 Independence Rd - Permits/Gas - Log, Line, Pipe - 12/07/1986of -vort luoinns BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
„ Applicant complete this part of form only.
Press firmly using ball point pen.
Job A46ress Icf^cJ T-j r)C vhtJ/C.
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Name A i' r, 1,�,,.f S
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Mail Address
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Phone
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Name 1%'+uw,,IT.4 ,.I FAST NTtl =,x, c .
Address SzoS ,rpL,l EGC
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License No- %1 rifll
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Lot
Block
Filing Number
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Subdivision
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PUD
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Parcel ri
DESCRIPTION OF WORK
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Stock Options
Plan No. Codes
Est. Total Cost f /1 �k ii , -
(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.
7 A4L_
signed
— CLA§.S OF WORK —
New Alteratlo Addition Demolish Move
❑ ❑.y ❑ ❑ ❑
Plbg. Mach. Elec. . Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area fj Height {
No. Stories ,
lot Area 1 'Frontage
Occ. load( j
Occ. Change fromf
Plat File No dNo,
D.U. ,
Garage area
Fin. esmt.rarea
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Type heat ' �.-�'i
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No., or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
1
Valuation f a: FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees,, r-'4
Distribution: Original - Applicant au', �Off¢e. Canary - Sales Tax Tag Blag�lnsp
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
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-via-
Street
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ZBA Case a
Date
BBACase# I _
Date
Building Insp. Approval
by is i date
c_ Permit -No. �--�_
Date