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Date Received: 1" 4 <br /> ' Date Approved: <br /> Permit#: 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 /> -------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS: 3S05 (L.�Pt Z4"-M zip:. <br /> PROPERTY IDENTIFICATION NO. : 3 c'� - I I -c�3 13 Oco <br /> (work) <br /> NAME OF OWNER: T- PHONE: (home)A`1(o- i3Z� <br /> MAILING ADDRESS: 35O�S �� j�.��.1p CITY: <br /> CONTRACTOR: ss - PHONE: A-X-6-A0ZCo <br /> MAILING ADDRESS: CITY: ZIP: <br /> ARCHITECT:k, � �C�.wlfd-�,� 5'�'tf3 I7� S PHONE: <br /> MAILING ADDRESS: Q.,1J} '�j �j C�, CITY: Q �1��� ZIP: 5�3�°I <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate' <br /> PROPOSED USE (describe in detail) : �X1��1►JC� _ i '�(aQs�c.Jy 1� r3 �-..! F � <br /> STORIES:_ SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: Ofd GARAGE STALLS: ATT.4Rr. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ i�-, �•� <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 accordancewiththe approved plan. \ <br /> APPLICANT'S SIGNATURE: _ Ol.car---s-�!! If — DATE: 1Cc I��ItI IM <br /> (Please fill out the reverse side of this form) <br />