HomeMy WebLinkAboutBLD1987-00366 •
N E
* 0 I. LOC
ATION: propraphic name S W SIDE OF /ROAD FEET
S W FROM INTERSECTION OF ROAD AND i_g y60 LQt.cL n LIC ROAD
other specific location or landmark: I3 W c,II. (� J
LEGAL DESCRIPTION:ar.lt, j Lot Block Subdivision
Tax Number Y.Section , ion Township`J Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
•
0 New building Single Family
❑New County Resident
„IRCAddition Multi-Family Is this structure to serve the residential
❑Alteration number of units or commercial needs of those employed
❑Repair,replacement 0 Hotel,Motel, Dormitory at either the US.Navy's Trident or
number of units Indian Island Facilities?
❑Wrecking 0 Mobile Home
0 Moving(relocation) 0 Other—Specify
❑YES ONO
❑Foundation only
n4c4 n JNtGt o+—1i4.�
f)orn.
USE
OWNERSHIP
.,,�4' 0 Private(individual,corporation,
0 Full-time Residence
nonprofit institution,etc.) O Second Home:Recreation Cabin,etc.
0 Public(Federal,State or local go✓t.) UBC OCCUPANCY GROUP: r —J 0 Second Home:Future conversion to
_ permanent residence
ii COST (Omit cents)
NII Nonresidential— Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary
To be installed but not included school,secondary school,college,parochial school,parking garage for
in the above cost department store,rental office building,office building at industrial plant.
a. Electrical If use of existing building is being changed,enter proposed use.�y
b. Plumbing I WO — WSJ [� 475r ,ID y0/ Frn
C. Heating,air conditioning
d. Other(elevator,etc.)
Jl
•
• TOTAL COST OF IMPROVEMENT $
--�- III.SELECTED CHARACTERISTICS OF BUILDING - u .
cL
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
O Masonry(wall bearing) •Number of Stories �.
Public or Private
•Total .
XWood Frame square feet of floor area,
Individual (septic tank,etc.) all floors,based on exterior
Structural steel dimensions
❑Reinforced concrete TYPE •F WATER SUPPLY •Total land area,sq.
❑Other—Specify
Public or private company h 730
NUMBER OF OFF-STREET
0 Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
O Gas Outdoors
OOil I
�4 � '� RESIDENTIAL BUI LDINGS ONLY
❑Electricity1_)
Number of bedrooms
OCoal 131--il./•-•4_ TYPE OF MECHANICAL '
Number of Futl
CI Other—Specify bathrooms
• Partial
_ r
IV. IDENTIFICATION-
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1. Y L k 3L/ Q f"5011_ / /6_ 2d 1 F566
Owner
2. OWIUER,
Contracto State License No.
3
•
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
i
Signaturerof applicant Address
L �� ' Application date
F `
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
6� 1�3, 1 ` �. •
JEFFERSONTH DEF'ART7.>ENT .
APPROVED Y: PERMIT FEE ISSUE DATE R�CEt4"T NUMBER
as.w
6� 71, , , -9- is�
BUILDING OFFICIAL `1q ,s
The Prinrrry —Parr To.+:wend `D El jc
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APPROVED
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