HomeMy WebLinkAboutBuilding Permit #12-0689 � o❑� c� a`�❑oo❑ � o a Z�
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��,/ ,��� TEMPORARY CER ATE QF ZOI�TING CQMPLIANCE
' �� f' � :, � AND UTIL CONNECTIQN PERMiT
�r �c�'
NNESD '
' `-'�"" �'` PERMIT NO. �� —6 ��
2 P1nt Ciry
3. Ydiwr Appiic�
ease or ' and s3 at bottom
ADDRESS ZONiNG �o� u�>
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LEGAL DESCRIP'PION (otHce use onty) !
LOT BLOCK A.DDITION ' PjD
OWNER � ' (phone)
(Name)
; (Address)
B�.D� / L- aG -.� - �o�, js� �7�� C
(Company Name) ( �' ! /
(Contact Name) - i� � - , ( F S - (I'hone) (^ �' C�
�A�> 7 1 � �..� C, e �: � '
TYPE OF WORg p Hew consnuca� �Deck �Ponh Roofmg �ReSidinB �Lower Level Finish ❑ Fireplace
�Additioa �Ainei'ati°n �Unhty C
CODE: �I.g.C. �I.B.C. ❑ M�
Type of Conskcacdos: I II III IV V A �°� �
Occupancq Gratip: A B E F H I M 8 U 1'gOJBCT COST/VALUE S —
Division: 1 2 3 4 S (�� 1 �
I hereby certify that I have fmn'shed ia6ormation � this a�pplication vrhich is 6o t,� oe�y mo� uue ema o�,�r. r�o a�ury �c i am ue o� o� �u�a �c � u�
above-men ' propeity aad that ' c�n('o+m to aII e�ristiug and bcat lavas and wilt pinceed in aoo�danc�e with submitted Plams. I a t6at the building
oil'iciat can this permit �� I haebY �m that t� '�ial or a dc�eee may e�r � t�e P�P�Y � P�O� �. .
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S;�p� cowrmxrn's Lia+�se xo.
Permit Valuation Park Su�ort F� # �
Permit Fee S SAC # $
Plan Check Fee S Water Meter Size 5/8"; 1"; $
State Surcharge 8 �'�� �°O� $
penalty $ SewedWaLer Connecxion F� # �
Plumbing Permit Fee S Water Tower Fee # $
Mechanical Pennit Fee $ Builder's Deposit S
Sewer & Water Permit Fee S � s
Gas Firepla� Perniit Fee $ TOTAL DUE a
Tl�is Apptic�ii� Bawmes Yc� � Prn�c W�e,n nnrwa Paid ' Recei No.
I?ate B •
BuildiH OflFcial 1�
'fhis is to ce�dfy that the reqixst m the above appliptiw and �a�ying � in �a�c wgh;the CitY Z�g O�na� ��Y P� ��t��. ThB docvment
when signed by tbe City Pl�rer co�tules a tempamy Ccctifica�e of Zoning and allows �uction to c�e. Befa�e accaPancY, a Ce�te of Occupancy must bc
i�aed.
�, � �, � � ��.. Speoal Cadtio�. if �y
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