HomeMy WebLinkAbout108 W Troutman Pkwy - Applications - 07/21/2003-W
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BUILDING PERMITS & INSPECTIONS DIVISION
P'()' 'I'*x -';So ' Fort C"! ns, L`O W522-05W - PhOne; 221-6760
BUILDING PERMIT APPLICATION
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use 4190Y LH, OR CA Wy PL ST CT-ki-nAvr
company Name License Number
D9 Address City
Atoe
JOB SITE ADDRESS,,,
subdivislowpuc
K19 Number Lot
BuWding Square Foolage
Number of Bedrooms"Bathrooms
ir, LN OR CR Wy Pt ST, CT RD- AVE,
superow & Cert, #
Block Lot AM
Number of Stories
I —
105hed Basemeni '4�uare Fiootage
Value of Consimetion (Including labok material. proup $ 32l 1 1 DS. 00
06wiption of Work:
Cx,
1 1-1 -
Zip Code
Zip Code
Zip Code
Buieing Heigh;
Suboutractom:
Electrical Mechanical Plumbing
Rooting Concrete
Other
I bet eby acknowledge that I have read this appl"Oon and stale that the aboveinjormallon is correctand agree to comely with all
requirements contained herein city ordinances and state laws regulating buiWig construction.eir a
Signature
Print Name Phone
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DistftAon Ofigoal - L A P Ye low - Wee