10165 SW WASHINGTON SQUARE 10165 S W Washington Square Road
IS1 35BA 100
sign (House of Fabr:.;s)
59010
A
59010 WHITE Impactor Cep
yE 1.1-OW P•,mIttN
PERMITNDAPPLICATION FOR BUILDING PERMIT PINK Tarwpofii.
GREEN Clreulatiention
WASHINGTON COUNTY H" DING
DEPARTMENT OF PLANNING ADORES Qf 4s ..0.,t) A� �di
BUILDING DIVISION LOCAL(IV
INSPECTIONS 618-8761 (AFTER 4 30 64035611 CRNEOSS STAREST
FOR APPLICANT TO FILL IN TgNsus IoltouPTYPE ZONE '
�- 1 j CONST.
ADDAESs/fwir $4I adif�yajii• .*4,
MIN/SETBACK if �S R
LEGAL DESCRIPTION /`/ .3.5- P+ APYO.MY DATE
'-----34--,AE- ai ZONING If' /--) i2.
PLAN ExAMINATION
r __.
AREA p OP LOT NOW ON LOTS STPIUCT.ENOR.
EXiTINO Sl DO TYPE OP SANITATION
OWNER NY
L. DRIVEWAY PMT,
ADDRESS —�
----1
CITY COMMENTS . a&I
ARCHITECT TSL. -_ - Ar
M ENGINEFR N
mg
ADDRESS
_— :6 ,
— �
CCNTRACTOR r TEL
RRWW11 A/�r N O..�yAI I
ADDRESS ' T »w'f .I ,fi`_
!7Y I
�.a_ ,_.,1E _ .../.....4-....
�
CITY SW't L1c.SLOE
V
DESCRIPTION OF WORK .--- .....k... 1 ) Ki
NEW ADD At TIP REPAIR DEMOLISH`- , (/
I. _..___ po__Cp_- —__ •----�
ZE T. ST`Piss FAIMIILIES —
SINO.BEDROOMS NO.OP BATHROOMS ---"414
USE Of __,
ATIMWASP
VALUATION$ .00 FEE FOR AMOUNT RECEIPT NO. DATE
P.C. PUT - -- ----- 1- _
PEE S FEES _ ST SAx / -� r
FRE S ZONING COMPLIANCE ,t, iG [,t:
I HERESY ACKNOWLEDGE THAT I NAVE R Ap 1 HIS 7
APPLICATION AND STATE THAI THE AIOVE Ia COR FIRE MARSHAL
RECT AND AGREE Tp COMPLY WITH ALL C UN VAR 1
OINANCES ANO STATE JAIMEG NO BUILD, SYSTEM DEVELOPMENT
CONST VCTION I
I•rgNAToPIE O `—"—T- ---
kRMITTEE �I _ ,
i
ADDPF c 0 - FINAL INSPECTION
'0 0 "ia.l ♦�• is A. GATE r
: • it72Z, 7 40''
PLAN HECK AIWA ION CK M 0 CASH PERMIT • IDATION CK M.O CASH �I
RECEIPT NO DATI RECEIPT NO DATE
I
y