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CITY 0!0 01146
BUILDING PERMIT APPLICATION TIG ARD DATE___
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
OWNER BUILDER PHONE
ENGINEER
AR HIT T DESIGNER _
UUILDER SL '—I ._
STRUCTURE ❑ ❑
NEW REMODEL ADDITION ❑ O
_
REPAIR RENEWr--11AL ❑I IRE DAMAGE DEMOLITION
C. RESIDENCE COMDR LTJ. EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT JJGARAGf_ L STORAGE❑SLAB ❑FENCE
❑.BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _ _❑SIGNS
pgCUPANCY LAND USE ZONE _ BLDG.TYPE..— FIRE ZONE— PLAN CHECK BY HEAT_
_OCC.LOAD FLOOR LOAD HEIGHT NO,STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE _
Permit
THIS PERMIT IS ISSUED SUBJECT TO ThE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL OF DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ..� ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERM11 DOES NOT WAIV
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURnUNT CITY BUSINESS
%State ' LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUNIBING AND HEATING.
Total
By
_ APF ANT OR AGENT
Approved Receipt No.
WE)DRFSs - HnNE
REMARKS PLUMBING DATE
DATE INSP. TYPE INSPECTION
Contractor
Permit No.
R uh-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Final
SEWER
DRIVEWAY
Final
Storm Drainage _
(Rain Drain) Final
Sidewalk---
Curb&Street Final
A roach
BLDG.DEPT.FINAL TEMP,�RAii_Y CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
1 /�;�
Address D G 4, J�,L�'_ 1cf Permit No. �-
Name of Occupant ;L4, Permit charge-_---_-________ _
---- —- — — Paid by--- ---��
Date connected
Type luilding C(�Q c: 6� — Inspection fee
Service Rate Paid b
- y - --- - Date,_-----____
Contractor_ ____._ _ Afsessment raid
Size of connection y ,