HomeMy WebLinkAboutBLD1987-00457f ,
I. LOCATION: yropraphic name S W SIDE OF Ohl1 j/000Lt.,f ROAD (p S 0 FEET
S W FROM INTERSECTION OF Pr.TatrSc' 1 ROAD AND OW ES,"-0"677I / ROAD
other specific location or landmark: D°fta dSk 'avme"
LEGAL DESCRIPTION: )C
go/3,Z b . . Lot Bioc Subdivision
�_ x " 9 cute - . .3 .4-3 2 v l i�/
Tax Number 4 Section Section Township Range
II.TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY .
i
New building 0 Single Family 0 New County Resident
Addition 0 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 ❑Mobile Home
❑Moving(relocation) Other—Specify ❑YES
O
q�[� ,
❑Foundation only "" - q
1
USE
OWNERSHIP
0 Full-time Residence
rivate (individual,corporation,
nonprofit institution,etc.) 0 Second Home:Recreation Cabin,etc.
❑Public(Federal,State or local gov't.) UBC OCCUPANCY GROUP: —/ 0 Second Home:Future conversion to
permanent residence
COST (Omit cents)
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.'
b. Plumbing ik
' /x 3 2 - 768 @ /1 � "'. lrJ t 'I 7 a
c. Heating,air conditioning -
er(elevator,etc) rt..
• TOTAL COST OF IMPROVEMENT $ f
} III.SELECTED CHARACTERISTICS OF BUILDING - ': -
4 • PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
0 Masonry(wall bearing) •Number of Stories f`'
❑Public or Private
g'Wood •Total square feet of floor area,Frame Individual (septic tank,etc.) all floors,based on exterior F.
Structural steel dimensions )
//�� 0Reinforced concrete TYPE OF WATER SUPPLY •Total land area, f {.qsq.ft. `.
't ❑Other—Specify • 0 Public or private company /75 F
0 Individual (well,cistern) NUMBER OF OFF-STREET
SPACES
t�� Enclosed _ -
PRINCIPAL TYPE OF HEATING FUEL , TYPE OF FIREPLACE I
Cr0 Gas Outdoors .
}
0Oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
0
Cog( TYPE OF MECHANICAL
Full
Other—Specify / Number of
bathrooms y'
• Partial
IV. IDENTIFICATION- •
Name and Address—Number,street,city Stateta ZIP code Tel.No. t
1. Fs�waro/ /4Std ^�/ la-0/ cote/ .5/r oc,-7t Jt'91-4=1�osm'—' �( 36$<)2c3A
owner , ./i,'f C" H'S Q ct of f.,(/' 73 iyq
2. pc-3 I.IC�-
E
Contracto State License No. 1-
. r
3. V - j
Architect 1
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of appl nt /f Address
1//� Application date
-Z-0-.--S.._-, '` ,(-._ 12�7 O / 54,--..0 vs., - A Vir /1 ,3/V/r
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
JEFFEFtSON COUNTY HEALTH DEPARTMENT -
APPROVED BY: PERMIT FEE ISSUE DATE RECEIQT NUMBER
MST °
., (o/ 7
....
s.„„\, ,r.... ,.. .
, . •
. .
BUILDING OFFICIAL -i p sj kl o, T . .. .._
1" ur.Fr. too
The Pr;nrery -- Pntt To.%nsend rio L`^ 3
9
` 7
-'---7( 4..,0 a 41- -----4:'----
T.
ei
.e-,cArvu-k ,c, \
-pv_oly : ;,
L
.„+...>1.__.
�^ 1 s
I
{
Va
ca
at, RI
s.
N (6'
� b _
fi -.-,'
N.
III
yi a _1flc
`
'
! -
I -.l I\
! i
1
t
I
1111 r