HomeMy WebLinkAboutBLD1987-00398 •
I. LOCATION: peopraphic name SW SIDE OF . W ROAD FEET
NE
S W FROM INTERSECTION OF ROAD AND ROAD
other specific location or landmark: F1%m _L U) LQ'4.011 I'/-�`t
LEGAL DE RIPTION: Su wisp n, \
Block i v f
�� l
00 ' Tax Number Y.Section Section Township Range
II.TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUl- . ING TYPE
�L ( PUBLIC WORKS APPROVAL
❑New building Single Family
❑Addition 0 Multi-Family
number of units Road Access Permit No.
o tion
0 Hotel,Motel,Dormitory Utility Permit No.
❑Repair,
Repair,replacement number of units •
Q Wrecking 0 Mobile Home &TlergefCy Services No.
Q Moving(relocation) Q Other—Specify Street Width A.
❑Foundation only D.e c r e f..ckv� �a niA
_
N,eui ?cc rt 0 likJ.l,ti B:
. Additional Permits Required:
OWNERSHIP
Private(individual,corporation,
nonprofit institution,etc.) 3
❑Public(Federal,State or local gov'L) UBC OCCUPANCY GROUP:
COST (Omit cents) Nonresidential— Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement S 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.
b. Plumbing
C. Heating,sir conditioning
t
d. Other(elevator,etc.)
• TOTAL COST OF IMPROVEMENTS �„),_ a
III.SELECTED CHARACTERISTICS OF BUILDING -
DIMENSIONS `'
i PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL •Number of Stories
•nry(wall bearing) Q •Public or Private *Total square feet of floor aria,
j� Frame Q Individual (septic tank
••• ,etc.) all floors,based on exterior
Z„Jdimensions
M Structural steel
TYPE OF WATER SUPPLY •Total land area,sq.ft.
concrete
Q Public or private company •
Other—Specify NUMBER OF OFF-STREET
•
0 Individual (well,cistern) PARKING SPACES
.`) Enclosed r
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE •
Outdoors
❑Gas
OOII RESIDENTIAL BUI LDINGS ONLY
Number of bedrooms
❑Electricity .
Coal TYPE OF MECHANICAL
Number of Full f
❑Other—Specify bathroomsPhial•
- 7
IV. IDENTIFICATION _
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1. dRc•.,� 3-.ter. P: r) . (.5 1 6 I y yg c) ,/. 7- ,
;..
2.
Contractor State License No.
f
Architect ryfl �
l The owner of this building and the undersigned agree to conform to all applicable laws.
! Swr'Q!+e of jr* APt *ion date
Kant ! A s s
. fp.41,u2_
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PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT 1-
APPROVED Y APPROVED '3Y APPROVED BY
k ,p- d kc s"/
JEFt 0• t EALn.4 PEF SHOLEL I NE DEPT. PLANNING DEPT. 1.1
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APPROVE BY: ( PERMIT FEE ISSUE DATE RECEIPT NUMBER
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BUILDING OFFICIAL
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