HomeMy WebLinkAboutBLD1987-00436 i- , , . •
0N E
I. LOCATION: p:oy+apnic name S W SIDE OF_c`-.
ROAD FEET
N E •Sw FROM INTERSECTION OF ROAD AND__J
other specific location or landmark:
PAL DE RIPTION: Subdsystion
t Block
n
Q(Q( 33 J 0 3 02 Ta■ N umber Y.Section Section ToOvrfship Range
II.TYPE AND COST OF BUILDING- •
TYPE OF IMPROVEMENT BUILDING TYPE PUBLIC WORKS APPROVAL
Q New building Single Family
Addition Iti-Family Road Access Permit No.
NO/Ainumber of units
Iteration Hotel,Motel,Dormitory
Q Utility Permit No.
Q Repair,replacement number of units
QWrecking 0 Mobile Home Emergency Services No.
Q Moving(relocation) 0 Other—Specify Street Width A:
Q Foundation only
B:
. Additional Permits Required:
OWNERSHIP
❑Private(individual,corporation,
nonprofit institution,etc.) /� 3
'II ) 0 Public(Federal,State or local gov't.) UBC OCCUPANCY GROUP: /"-'
r"` 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.
If use of existing building is being changed,enter proposed use.
a. Electrical
jb. Plumbing U .c.CCtai hatl]t ' ( opt
‘L-----
... Heating,air conditioning W ft.J t/`t
d. Other(elevator,etc.) vvV
• TOTAL COST OF IMPROVEMENTS (OD 1
III.SELECTED CHARACTERISTICS OF BUILDING n J a
--�jj ��(�{�{� DInnENSIONS i {
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DIS;0% ( •Number of Stories
C'
QMasonry(wall bearing) *. O Public orPrivate �* *Total square feet s floor area,
od Frame d�fndividuap (septic tank,)etc.) all floors,based on exterior
\ _____.--j dimensions
QSutsctural steel '��� ---LTYPE OF WATER SUPPLY •Total land area,sq.h.
Reinforced concrete P� c• • company
Q Other—Specify NUMBER OF OFF-STREET
ad (rvel�astern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE Outdoors ...
Ges❑Oil RESIDENTIAL BUILDINGS ONLY 2j 'IC
Number of bedrooms
Electricity VIOWIlltTYPE OF MECHANICAL l if
0 Coal Full l
Number of
❑Other—SpedfY bathrooms Partial r _}
IV. IDENTIFICATION
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
f
Owner .\ 0 L i. i ►di ..r •
I.
•ntraaor , 1j'= rl 4111 - . . L • II2971
/ ' _ :: l��l �;■ �.mmo
a t �iem � wJ � [ ' AW
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The owner of this building d the undersigned agree to conform to al)applicable laws.
f apple Add
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///11-(2__ 4 .—:-., rrt. ad a
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BYG —tom b G, APPROVED 3Y �� APPROVED BY
arc � ,
��'rft DE nE N® b\S7 PLANN I NG DEPT.
]EFFETZSON SHOP.EL I NE DEPT. \ � �.
(PE MIT FEE ISSU DATE R1=CEIPT MUYBER
APPROVED Y: SC?, S •
30'-/ D
/ „SD 06 /30/8``? (9)
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BUILDING OFFICIAL C 7 \\., �� no _
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