HomeMy WebLinkAbout604 CORNELL AVE - PERMITS - 10/1/1986ALC FSi200WFZs �VLT'S Y�1 ■
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APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address
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Name :�^
a)Mail
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Address", -'r
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Phone ... f
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Name
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Address
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License No.
Phone
Lot
Block
Filing Number
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Subdivision
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PUD
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Parcel #
DESCRIPTION OF WORK
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Stock Options
Plan No. !:C Codes
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Est. Total Cost �r
(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.
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— CLASS OF WORK —
New Alta ti Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building r
FloorArea ht
No. Stories
Lot, Area (
FfonF @ J-
Occ. load
cc. Change from
Plat File Nq
No. Ij,lJ:
Garage area
. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Feesc—
slgne ,y date
Distribution Original - Applicant. Blue - ONice; Canary - Sale6 Tax: Pink - Applicant; - Ta- Bldg. In59�_ ..
Off-Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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m
m
65
m
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Street
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ZBA Case #
Date
BBA Case #
Date
Building Insp. Approval
by date
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Date