HomeMy WebLinkAboutBUILDING 08-0961
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BLOCK
PID
OWNER A~ I
(Name) A' I J {\. e..
(Address) 1'111"
"
j/ie ( 5011
/)} . j l
It:../l."e (;HrOJ'
(Phone)
6/) - CJicr..{;7:l/
71-
;f)e
BDaDER j) j" '
(Compa"y Name) aJr:.f. S~ro;(" //e/-ur L
(Contact Name) .,.. ,i. hit 5
(Address) lJl81;u,r.t...1 A c /v/
(Phone));; 3~ f..71-;LOO?
.
(Pnone) S-07-t:'/6 v-o;rss-
$3/6
TYPE OFVVORK .0 New Construction ODeck. OPorch Jt1'Re-RoQfing ORe-Siding DLower Level Finish .0 ;Fireplace
OAJ;ldilion OAlteration o Utility Connection
CODE: OI.R.C.DI.B.c.
Type of Construction:
Occnvaricy Group: A B
Div;ision:
o Misc.
I II III IV V A B 8;- '. .
E F H I M R S U PROJECT COST/VALUE $ . t ~,~;,;...
1 2 3 4 5 {e1!:cluding land)
I hereby certijy;that Ihave.fumished jhformationonthi~ilPplication which is to the best of my knowledge true and carrece. 1 also certify that J a'm the owner or authorized agent .for the
above,mentJoI1e~ property and that all con~truClionwiU conform to all exi~ting state and IocalIaw~ and will proceed in accordance with submitted plan~. I. am aware that the building
I.. Offi".aI ca....ri reva. ~e. .thiS. p. e. .r. m.lt. ~. 0..., '.Ju.stcms.e... FlI.rthermore'.1 hereby agree that the. City. Official. or a d." e.~...ign.. .e..e ma. ...... .Y...efi.t. cr.. '.UP." ...on..... ....t.h. .e.:Pfoperty. ". to. p. . erfOrmneCd.C..d msycct.. IOrt~.
X ~f!'.~ '. . . 'blOS'2~~s:r '.. /l-go~ag
Sigtllature . Contractor's Liciense.No. Date
Permit Valuation
Permit Pee
Park Support Fee
#
WaterMet~Size5/8"; I";
. Pressure RedUCer