HomeMy WebLinkAbout808 Garfield St - Permits/Addition or Alteration - 01/28/2004ty o
S 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 Address •d,t
Name Jf.- ,r„ v'(/G•J^xl..
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Mail Address }� i1 •, .l jt, �•-!s %/
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Phone
Name1r fGrf !1 r.0
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Address ;,i 'j -, }. ,' ..�. 11r-+'• ! -
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License No. �_ 7 7
Phone.7a7 f 4')
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lot
Block
Filing Number
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Subdivision
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PUD
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DESCRIPTION OF WORK
7, •,
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c'r;' ire. r,r '�✓r.
I
(Stock Options
Plan No. Codes
f� 1 a �
Est.
Total Cost •''
(including labor, material, profit)
II 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
— CLASS OF WORK —
New Alteration Addition Demolish
❑ ❑ ❑ ❑
Move
❑
❑ ❑ ❑ . ❑
Plbg. Mach. Elec. StruaZone
Occ. Gr, Type Const.
UseUse
of Building
FloorAreallo.
Stories
Lot Area
Fro
Occ.load
Occ. Change from
Plat File No.
No. D.U.
Garage area
Fin. Ssmt. 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
JJ '�
n�stiibuUpr4,0a[Jinal - Appl¢anl. Bluet'UIfiGG Canary - Was Tax: Pink - ADPIi<ept tag - Bldg Insp.
Off -Street Parking
(No.
Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBA Case N
Date
BBA Case k
Date
Building
Insp. ! Approval
by
date
Permit No.
Date
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