HomeMy WebLinkAboutBuilding Permit 12. 1041 au)
z 1n
3 w Iii < * 0
w
0 ..],. 0. O. a. 3
o Uu.tit�\ w 3
\ >
o cc
U O
• w =
0
V u, r O
{� � k w O O. O. � � m c Q i , CJ �
5 g k.
(� ❑ ❑O❑ ❑❑ re x O w , �
\� a a u.
Z J
0 a c a p
ww t - z o
5 P z U o co
oz o 0 w H a I W
1...
ri a (.0 ° z =e3 J z w x
Lo 0 0 IX
W ", a
U. U w " a' 3 U 0 0 V
Ow re w Z ggu) . a ce
% 0 O u. u. u.3 u , v
0 z < O a 0 000❑❑ 0 0 0 S
mil' CITY OF PKIOK LAKE BUILDING YEKMIT, r Date Rec'd
U , T EMPORARY CER'1'Ir1CATE OF ZONING COMPLIANCE /
AND UTILITY CONNECTION PERMIT
IIr
1. Fink City PERMIT NO. (Z j 0 4, f
3. Yellow Ap apt
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ 4-4- 7th 6 1ue(ov..c, Trot_ 1 Ai E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) Ly-'r'e VIA cC_JC (Phone)
4-
(Address) / 7 7- alLic_ (r1 fro( Tp--, f l ,4
BUILDER �
(Company Name) fli/Q fZ €sS t v t tt Oi 6CJ) _ (Phone) l -f 3 —
-- C
(Contact Name) C,.4 i fl "' t'' (Phone) 7‘..S 3 70 —00 7
(Address) J
TYPE OF WORK [ New Construction [Deck [Potch i t Re Roofing DRe- Siding DLower Level Finish ❑ Fireplace
0Addeion E3Altetation [Utility ■ ,
CODE: DLL C. DLB.C. [ Misc: 3 s S
Type of Construction: I 11 III IV V A B Od
Occupancy Group: A B E F H I M R S U PROJECT COST ALUE $
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fannshed information on this application which is to the bar of my knowledge true and coned I also certify that I am the owner or authorized agent for the
above . . and that I mamma to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
o', ' . can 1 this permit , .O I hereby agree that the city official or a designee may eater upon the property to perform needed
X r / .rrl /t 1 . I c6'... 2 7 /a /
Signature Contractor s License No. r e
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becom s Your B Pest When Approved Paid l .1 ceipt No. 6l() qo ,
Date q, (2/
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
s• �_�_ r.ae__ s .,n �._..._�__ . inrw� Aw4 noen s._ �nrn� wwn .rswr