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HomeMy WebLinkAboutBLD1987-00459 .CATION: peoprsphic name • Fir S WE SIDE OF . ROA (Y\ FEET II Y \ NE • N �l/ JP ' .. 44 S W FROM INTERSECTION OF + ROAD AND . u �� ROAD ocher specific location or landmark: hi1 r' f r F- C1 (if/1 d ( LEGAL DESCRIPTION: ( ( /( T %r_7- � - 7i2r/ j RI-)(1 l_.__ -1, i Lot Block Subdivision x )( x O Tax Number Y.Section Section ownship 1Range c\J II.TYPEANDCOSTOFBUILDING - �_ k) TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY • 7/' 0 New building ElSingle Family 0 New County Resident / 0 Addition 0 Multi-Family Is this structure to serve the res:.ential number of units or commercial needs of those mployed I' ❑Alteration ❑Repair,replacement El Hotel,Motel, Dormitory at either the US.Navy's T'dent or number of units Indian Island Facilities? t ❑Wrecking /� ❑Mobile Home t ❑Moving(relocation) Other-Specify 0 YES "NO �F • .�v,i ❑Foundation y -� fA (.U(DC,o }-.)vi, USE OWNS IP 0 "ull-time Residence Private(individual,corporation, 11 Second Home:Recreation Cabin,etc. nonprofit institution,etc.) ❑Public(Federal,State or local gov't.) UBC OCCUPANCY GROUP: 3 0 Second Home:Future conversion to permanent residence ' COS 4 (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 i uded school,secondary school,college,parochial school,parking garage for in the above cost s department store,rental office building,office building at industrial plant. • a. Electrical y \ If use of existing building is being changed,enter proposed use. r b. Plumbing. 1 1U• g air conditioning XYcJ r— ,ale . Other(elevator,etc) \ ( • • TOTAL COST OF IMPROVEMENT $ \ f, i 1 III.SELECTED CHARACTERISTICS OF BUILDING - _ I'," DIMENSIONS �--'•, PRINCIPALTYPE F FRAME ,!-LTYP OF SE WAr F DISPnS t. ❑Masonry(wall bearing) ❑Public or Private •Number of Stories •Total square feet of floor area, .. ❑Wood Frame ❑Individual (se. ' tank,etc.) all floors,based on exterior e dimensions ❑Structural TYPE OF ER SUPPLY •Total land area,sq.ft. "' ❑Rei reed concrete r (". 'ublic or private company [•__ • "� Other-Specify NUMBER OF OFF-STREET i ` i ❑Individual (well,cistern) PARKING SPACES - Enclosed PRINCIPAL TYPE OF HEATING FU TYPE OF FIREPLACE ]*.°w ❑Gas Outdoors _ ► f,-2 ❑Oil RESIDENTIAL BUILDINGS ONLY l"'`- r Number of bedrooms ‘2 0 Electricity -1 : TYPE OF CHANICAL ❑Coal J Full I' her-Specify Number of I bathrooms V Partial IV. IDENTIFICATION- . Name 3Rs- _z S Mailing Address-Number,street,city and Statepp ZIP code Tel.No. t_ Iv Ptf'wiisCI'_.57: AO bog sr Fars S 'NO A'-% C ith's6j 2 .l1N1 qb5i,1 3P5Y73t) Per (if fi i✓6MV,. w�9 if��i i63 771k-ft /15. aP/in (ig !2. l' / I 0. O ���j� / 2 al-y7 lWC 7 E ' Contracto ate f770 _re se No. > 3. - . (S r-rs ? e\A' .c.- 3 PS-.k Si.SI. Architect ` . r The owner of this building and the undersigned agree to conform to all applicable laws. Signatu►yof applicant Address e-y., 2 'l Application date f .X /4: )-, 4276/71 P .A iZ_Zie,,A-74 X --,A,-/-r i2/2'L 1�-� 7 1 PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY F JEFFERSON COUNTY HEALTH DEPARTMENT - APPROVE BY 5PERMIIT FEE ISSUE • RECEIPT NUMBER i 07 S. f STD —Amitetora (D. q C( ... 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