HomeMy WebLinkAbout1512 Teakwood Ct - Permits - 05/03/1983S BUILDING INSPECTION DIV1510N
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address rf
Name
c
Mail Address
3
O
t
Phone
Name
0
u
Address r
o
r=
U
License No. —✓,a, -
Phone ..- p' . � .' k
c
2
Q
Lot
Block
Filing Number
y
Subdivision
PUD
rn
d
J
DESCRIPTION OF WORK
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.
f r
r
v
signed date
— CLASS OF WORK —
N w Alteration Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building q ra/e+
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 V
FEES
Permit
G'iJ
Plan Check
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
City Sales Tax
�� :_+; ,:r 7—
Total Fees
J 6.<�
Distribution: Original - Applicant; dyC]Otthqe;4j4Mary - Sal axair*-,Q 14'Mlod"sp.
1. a - ..
�•'e � r�.yey ti.� ry fi
Permit Np.
Date
10411,
rifly 0 5 1883
m
a
m
O
ZBA Case #
Date
BBA Case #
Date
Building Insp.
Approval
by
date
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
v
m
Y
cc
0)
m
IV
c
to } N
C
0
LL
�J
Street