HomeMy WebLinkAbout644 PETERSON ST - PERMITS - 12/28/1984City of Foifti C011iflS 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
Name
c
Mail Address
3
O
Phone
Name
v
Addressva
c
0
U
License No.
Phone
c
s
n
Lot
w�
Block
Filing Number
Subdivision
A
PUD
DESCRIPTION OF WORK
.L I}tlNLlg.
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, mterial, profit)
I hereby acknowledge that 1 have read this application and
Mate that the above is correct and agree to comply with all city -
ction,
or Inance and late laws regulating building c4da
A.A — - - 4
_A4
signed
— CLASS OF WORK —
New Alteration Addit'on Demolish Move
❑ ❑ ❑ ❑
Plbg. Mach. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑
Occ. Gr. Type Const. X
Use Zone
Use of Building t I(r XI
FloorArea -] ? 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 nj -iGt /� Z - CIA, _t _
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
S(;7
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
UUtnbUnon:I Original - Applicant, Blue - Office; Canary - Sales Tan: Pink - Applicant: Tag - Bldg. Insp.
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
=1
w a
m
m
rc•%
d
� c
yJLL
Street
T rtI
{o' '!P (1',
C
W
v
ZBA Case ti Date
BBA Case N Date
Building Insp.
n Approval
SZ
-by date
5 -7,fl
lz-
Permit No.
Ddte t '