9475 SW WASHINGTON SQUARE ROAD 9475 SW WASHINGTON SQUARE ROAD
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PLAN CHECK APP1,'rAT3ON
PLAN CHECK
PERMIT
DATE ISSUED
JOB ADDRESS: _j�,7� _ ((,r / ,S - TAX MAP/LOT
SUB:_ LO , _ _ LAND GSR:
VALUATION: A j ���� SETBACKS: FRONT: REAR: LEFT: RIGHT:
-
WORK. CLASS: HEIGHT: TOTAL. AREA:
USE TYPE _ FLOOR LOAD: IST:
GONSTR TYPE: _ HEAT TYPE: 2ND:
OCCUP GROUP: DWELL/UNITS:� 3RD:
OCCUP LOAD: NO BEDROOMS:- BASEMENT:
NO STORIES: NO BATHS: —� GARAGE:
IMP SURFACE: —
APPROVALS RE0Q'D SPECIAL NOTES ITEMS REQUIRED
PLANNI'NG:� REISSUE OF: _ LIST/SUBCONTRACTORS:
ENGINEERING: LAST REISSUE: BUS TAX:
FIRE DEPT. : — FLOOD PLAIN/ -- CALCULATIONS: -�—
OTHER: -� SEN LND.: TRUSS DETAILS:
-- — PARKING PI.A.N: ��---
I ANDSCAPE PLAN: -�--
PLAN CHECK BY: CTH
- _-
^— CCT f 7 "b 3VTi"off"—� AMOUNT
OWNER 10-432 Building Permit Fees
1 Lv 10-431-600 Plumbing Permit Fees � 4
ADDRESSe ,, �", 10-43,1-601 Mechanical Permit Fees �
_- - 10-230-501 State Building Ta: (5x)
_� - 10-433 Plans Chuck Fee
PHONE:— fd2i� �� (, - 30--443 Sewer Connection (20%) t
30-202 Sever Connection (80X) S
CaNTRACTOR 0-444 Sever Inspection t
NAME:_(. 'x,11 r� ,,, ,k 1-448 Street System Dev. Charge (SDC)
ADDRESS: - 52-449-610 Parks I System Dev. Charge (PDC)
4�,,,-I- o rz, ri-12 i� _ 52-449=420 Parks II System Dev. Chargc (PDC)
31-450 Storm Drainage Syst Dev Chrg(SSD(:)
PHONE: Z 4�j- h l; 10-230-505 TRFD (95X) t _
10-435 TRFD (5X)
AR-OH/ENGINEER 10-230-506 Washington County Fire /1 (95X) 3� <
NAME: 10-435 Washington County Fire /1 (51) t-
ADDRESS:- 10--:20 Kmart/Wedgewood
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-- -- -- �--`- TOTAL
PHONE:
PREPAID fi
RITC t
BALANCE DUE 4
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RPCPivPci QACP Rcr_eiveri:
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