HomeMy WebLinkAbout2190 W Drake Rd - Permits/Tenant Finish - 03/12/1984"Cl Mks Of Forty Co11h-n' BUILDI G 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 ;), J ?) 4VA A ail C )fj
Name I �' r^ x
c
Mail Address
3
O
Phone
Name }
m
Address 13
c
0
U
License No. :' - �/ Phone `fir,?- j
c
.a
Lot Block Filing Number
Subdivision
PUD
d
DESCRIPTION OF WORD
r
_1"
J
r
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.
s' '-.a2-`la�s.':3"�O'� '`"�-ai.a� ,,,�3'Jl�,•c...e�, '..a i �f �I
signed date
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prof,
❑ ❑ ❑ ❑ ❑
Occ. Gr.,.
Type Const.'-
Use Zone
Use of Building
FloorArea i
lHeight
No. Stories
Lot Area
Frontage
Occ. load
Occ. Change from
Plat File No. !
No. D.U.
Garage area
Fin. Bsmt. area
Type heat iNo.
Fireplaces or stoves
— RELEASES — Dates
Zoning
i
I
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Cond'tions:
i
i
I
i
I ,
Valuation FEES
Plan Check
Permit
Parkland
i
City Sales T4
St. Oversizing
Water Plant li ivestment
Sewer Plant I ivestment
Storm Drainage _
Electric Underground
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot ❑
v
m
}
m
a�
15
( )
m
C/3
0 in
}
c
v,
Street -
kofts
TAXPM 47LIC9 1
02231"
11119TA 104.10
o hAR.0%'84
C!!C!t 10 1,
cc N92704'14227
A
cc MAR.12'84
ZBA Case #
Date
BBA Case #
Date
Building Insp.
Approval
by
date
Per.
Date
10