HomeMy WebLinkAbout05030068-ApplicationRECORD:
OWNER:
Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PHONE FAX
STREET ADDRESS
LOT #
a PRO3ECT
TNFO: ~OOeESS oF co,sTRucno,
SECTION
SEWER IJT~LITY WATER UT1LTTY ESTIMATED COST OF (
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COHHISSION / BZA / ~PW DOC~'T
NUMBERS:TACDATE(S);AND/ORCOUNTYWELLAND/ORSEPT[CPERMJT#S(,FAPPLICABLE): //~/~ ~ ~/-~/ ~
E] SINGLE FAMILY
_~OWN HOME
# of units:
[] MULTI-FAMILY
# of Units:
C~l RESIDENT[AL (For
Additions, Remodels, Etc.)
P~= _-= I'N =----'--A :---:
Early Release
Permit: ~
Lot Split:
- E '- R . M, T: PL_ BZN. CONT_-CTOR:
~R~MSTRUCTURE
ADDITION(S) Plumber's Zodiana Stab
[] PORCH ADDITION(S)
[] REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
' ~DTFACHED GARAGE
EMOLITION
Manufactured
Trusses: ~ N
Does any part of the property lie within a special Flood
SQUARE
Which p
Plum
(Multi-Family Construction Code)
~~L~: (Check all that apply for
USE ONLY: ************************************************************************
Filing Fees: ~
Base Inspections:
Cert. of Occupancy:
P.R.I.F,:
TOTAL:
Charged Re--
Reviews
Additional
/
Services (Date)