HomeMy WebLinkAboutWsehartpermt(front),M
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9 —2 - 08 Permit Number:
Building Permit Application
(n i 3_3i._� COP 3z-)J-JZ411-:9-�1�
PropertyTax ID#: �-1
Site Plan Name
Project Name:
Setbacks Front Back
Lot No.
Right Side: Left Side: 1/
iditional work to be pertormed under this permit - check all that apply:
'Mechanical _Gas Tank - Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ -?!y 0 0
Name VD Il \-&J %5 E t� -f
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
Address:
City: `� - �-• State: � -
Zip Code: Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: C. '1&®\C\Y k\/
Company: Al C,:
Address: cl! 7 �'t ScA.s KC- .C✓^C\k4:f-/J 1W
City:. L • State:'
Zip Code: S `i. q S-3 Fax:
Phone No 15'4
E -Mail
State or County License 1814 Z-71
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.