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yrs O y' - .JIM; I9,y ,y ^yh r( <br /> 1 <br /> > Total Fee: $ , SZI Date Received: h7 (68 <br /> 1 <br /> VIL �r Date Approved: E-`� kx- <br /> Act i tell -R4g� ) J Permit#:/ 0 f3 Project#: <br /> Building Permit Application Requirements: <br /> 1. Building permit application - to be filled out completely and signed <br /> 2. 2 sets of construction plans to include the following: <br /> a) Floor plans; <br /> b) Footing and foundation plan; <br /> c) Elevations (of all sides) ; <br /> d) Wall sections and cross sections; <br /> e) Details - stairs and any special connections. <br /> 3. Certificate of survey with location of existing and proposed <br /> structures including hardcover calculations and grading and drainage , <br /> plans as required. <br /> 4 . Energy calculations - form provided. <br /> 5. Septic report and design if required. <br /> ABOVE INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR 1 <br /> JOB SITE ADDRESS: /�7xNs �%0tv/-fig w°,I P d. ZIP: ,S-5 .?? / 1 <br /> PROPERTY IDENTIFICATION NO. : <br /> /14 (work) <br /> NAME OF OWNER: C7. /�U f rJ ft °'� PHONE: (home) y7/-,WQ2' <br /> MAILING ADDRESS: /3C S 7-Er'iKif%-.4--)-4 k P CITY: LJy Z-t')l ZIP: SS-37 <br /> CONTRACTOR: &Fe PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> ARCHITECT: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration , 2' c <br /> PROPOSED USE (describe in detail) : &e--. 4;), ' 11(0l" 474 Ci/'''4 <br /> oti e, 6w bf P0-0(,(PF6l- A4,v- fN( 0.71' New TReie-c <br /> -7% LA-- f`C"4". - K.0 EEQ I 00 'C-Lb t c- '/Oc(z--1;› ! I 1 -4-- G v- "Per-wet`!- <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accordan e with the approved plan. <br /> APPLICANT'S SIGNATURE: 4.-4 s*!J DATE: C - 7 - r7 <br /> (Please fill out the reverse side of this form) <br />