HomeMy WebLinkAboutBLD1988-00396 14— r. E
I. LOCATION: geographic name S w SIDE OF ` ' ROAD FEET
N E f / /�. �f r
S W FROM INTERSECTION OF ROAD AND} / L (t..A. f)-(t-e... i OAO
other specibc location or landmark:• P
LEGAL DESCRIPTION: SuOviss.
Lot Block �x/'-,/ +)vfv/
Tax Number Y.Section ction
Township L Range
II.TYPE AND COST OF BUILDING- •
TYPE F IMPROVEMENT BUILDING TYPE PUBLIC WORKS APPROVAL
New building 0 Single Family
Q Addition 0 Multi-Familylj Access Permit No.
number of units
Q Alteration Hotel,Motel,Dormitory
Q Utility Permit No.
Q Repair,replacement number of units
Q Wrecking 0 Mobile Home Emergency Services No.
[(Moving(relocation) Other—S 'fy Street Width A,
Q Foundation only
B:
-( Additional Permits Required:
OWNERSHIP `�n G7Q
0 Private(individual,corporation, ' �I 1
� nonprofitl etc.)
r\rl 0 Public(Feinstitution,
eral,State or
local goJt.) UBC OCCUPANCY GROUP:
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
3` 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 chap ,enter use.
b. Plumbing
c Heating,air conditioning
d. Other(elevator,etc.)
YI
• TOTAL COST OF IMPROVEMENT S
^III.SELECTED CHARACTERISTICS OF BUILDING -
DIMENSIONS
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL •Number of Stories
Q Masonry(wall bearing) 0 Public or Private '' •Total square feet of floor area, )
"gWood Frame 0 Individual • is tank,etc.) all floors,based on exterior
dimensions , ,
r.
tructural steel /
TYPE OF - ER SUPPLY *Total land area,sq.tL
Q Reinforced concrete 0 •r.lic or private company
Q Other—Specify NUMBER OF OFF-STREET
la Individual (well,astern) PARKING SPACES :
Enclosed '
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE Outdoors ._ 3;;'
Q Gas _
❑OII RESIDENTIAL BUILDINGS ONLY
/ Nurnber,Of bedrooms
Q Electricity
TYPE OF ME ANICAL
Q Coal - tribes of Full i
Q Other—Specify throorns Persia/ fD
q 1 .IDENTIFICATION / -
\ Name Mailing Address—Number.street,city and State ZIP code Tel.No. --.
"~ c�, m �11 � t? Use- (.� > > .� -s Q
Owner p / ,
I
2 State License No.
..
' Contractor I
fl 3. f
-
Architect J t
The owner, his bitilldir Ithe/undersigned agree to conform to all applicable laws.
j date i
�'%` `�syc J , '{AZ ft ion; _ `�
FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT I
PLANNING AREA
r
APPROVED BY APPROVED '3Y APPROVED BY
y: ;t-, - �" I
- Th DE" SHOP,EL I NE DEPT. PLANNING DEPT.
-t ' ril ISSUE DATE RECEIPT wUYBER
APPROV '1 ! L �I�FEE
3/71i ...9 ci ,(:) (..0 (--/ . ._.-..
BU I VW FAIa{Myf�j °" , TY �� N.S EJ
I I P7
/ 0 CI be r✓ - Port To.+nsrnd _
f/vAi) I
t
APPROVED
MAR 8 1988 ----4;*-1 1.16G oyPeA444.1s
JEFFERSON COUNTY
PLANNING&BLDG DEPT
A..{014A- l..r G UItl�n� iwir
?/A9 /-71-4
/SPO—C7