HomeMy WebLinkAbout612 REPUBLIC DR - PERMITS - 9/7/1988or --r'ort-- UIDELMs
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ballpoint pen.
Job Address
Name r 1
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Mail Addressd
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Phone x
Name ,s
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Address
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License No. .Z-19Phone 201 .;`
Contractor Sales Tax No.
Lot
Block
Filing Number
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Subdivision
A
PUD
m
Parcel #
DESCRIPTION OF WORK
i
I
Stock Options
Plan No. / Codes'j
Est. Total Cos ee--p
(including labor, material, profit)
I hereby a kf)bwledge that I have read this application and
state that th b6ve is correct and agree to comply with all city
ordin e d ate laws regulating building construction,
4�e- 4 -A<.e '4��p
sined date
— CLASS OF WORK —
N Alteration Addition Demolish Move
❑ ❑ ❑ ❑
Plb . Mach. El Str Fire Prot.
❑
bcp Gr. Type Cory�JttV tj
I Use Zone
Use i :wilding �!
Floor Area r115XI! `=
Height / le
TD '
Lot Area
Frontage
o Occ. load
Occ. Change from
-Plat File No. r `tG a
No. D.U. j
Garage are
Type heat
No. Fireplaces o ""
— RELEASES — Dates
Zoning ((30- S
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review C
z.
Special Conditions:
s
Valuation FEES
Plan Check
Permit
Parkland
L.
City Sales Tax
^� 7
St. Oversizing
•�•y
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
1
Total Fees
Distribution. Original - Appliciint: Blue - Office, Canary - Sales Tax. -Pink - Applicant. Tag (!6f 8. Insp,
Off -Street Parking
(No. Cars)
Interior Lot jy-
Corner Lot ❑
Reversed Corner Lot ❑
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1131 t jv;
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Street avrr c • qc nn
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ZBA Case # Date
BBA Case # Date
Building Insp. Approval
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Permit No.
Date