HomeMy WebLinkAbout1236 Sioux Blvd - Permits - 03/12/1984aCity of
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Ort G`61-Linn I 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 1236 Sioux Blvd.
Name Melody Homes
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Mail Address 11031 Sheridan blvd.
3
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Phone466-1831
Name °Melody Construction Co.
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:7% same as above
Address
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License No. B 35
jPhone 466-1831
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Lot 1
Block S
Filing Number 2
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Subdivision: „-; Wagon Wheel
PUD
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x DESCRIPTION OF WORK
Plan 1275
Stock Options
Plan No. 159 Codes. A
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 ands ate laws regulating ullding co stru tiopn
signed Ifte
— CLASS OF 'WORK —
NeyV Alteration Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr. R Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories ill L
Lot Area I £
frontage , f
fi]c. load
Occ. Change from
Plat File No.
No. D.U.
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves (J
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
Permit
S -7
Parkland
%
City Sales Tax
St. Oversizing
w "
Water Plant Investment
t
Sewer Plant Investment
Storm Drainage�—
Electric Underground
E
Total Fees
Distribution- Original - ApplicanC Blue- OF c'e, Canary - sales fax �4- Applicant; Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot
Corner Lot
Reversed Corner Lot
❑
Y
m
am
a
_'V
r
l 44
� m
0
JLL
f '
Street
c
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ZBA Case #
Date
BBA Case #
Date
Building
Insp. Approval
by
date
Permit No,
Date