HomeMy WebLinkAbout913 Grouse Cir - Permits/Footing and Foundation - 04/22/1988Page is too large to OCR.
City- lt) IH-b C6111r1S BUILDING INS ACTION Di fSION
APPLICATION FOR BUILDING -PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 3e
Name
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Mail Address
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Phone
Name ,
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5
Address
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License No.
Phone is r
Contractor Sales Tax No. �+
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Lot :2
Block
Filing Number
N
Subdivision
o
70
PUD
Parcel # ..
DESCRIPTION OF WORK
7 ,
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
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
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
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
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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Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
Permit No.
Date
Distribution: Original - Applicants. Blue - Office: Canary - Sales Tax Pink - Applicants, Tag - Bldg. Insp.