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05120018-Application
BUZLDER of RECORD: OWNER: ~MA~L ADDRESS PHONE & PRO3ECT ZNFO: hetl Building (If different than Address of Construc~on) Lot # and Subdivis~on (If Applicable) SCOPE(S) OF 0 FDN C PLUM SQUARE ~Em~SE: ~;~C a SP~R OTHEr(S): mOT^~: ~ ~-- ~D ~ ~ C~U~: PRO~O~: - (~CLUDING ~D V~E) c/ COUNTY WB.L AND/OR SEFTIC Pt~HIT #'S Cfi Applicable): ~] ~o BLDG ar( CRAWL SPACE NEW STRUCTURE ADDITION [] Room(s) C~ Porto C3~REMODEL ! !~ C:) NEVVTENANT F[NLSH ACCESSORy BUILDING C~[ DETACHED GARAGE~, ~ ATTACHED GARAGE: ~ cELL~roWE~ CNeW) :: ~ :;CE~ ~OWE~ CO-LOCAT~ [] DEMOLTFJON designation area: Y N · Ucense # OFFZCE USE ONLY: ************************************************************************ iNSPECTiONS REQUZREDJ Filing Fees: # Charged Lower Footing Under Slab Base Inspections: / ',~ Renews AddRio~l F~ t Services (Date)