HomeMy WebLinkAboutBuilding Permit App.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dare II J G I Juz 1 Permit Number:
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Building Permit Application
Plonning and Develcpmen t Services
Building and Ode Regulation Bresnan Commercial Residential ee-
23WValinioAvoum,Fall PiermFt34982
Phone: ITRI E62-1553 Fax: 1772) 4621578
PERMIT APPLICATION FOR: C
'CAQTIO -1P moor
PROPOSED IMPROVEMENT LOCATIO .
Address:.iOt3 Cs:AJrif ncsc1 PL
Property Tax ID p: Lot No.
Site Plan Name: Black No.
DETAILED DESCRIPTION OF WORK:
fPnlri El K-` fnr N2a�GvaoC ckvr iy�{1 Snyne SFe
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New Eec:rlca l M eter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters <Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq: Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 16n Utilities: _Sewer _septic Building Height
OWNER/LESSEE:
CONTRACTOR:
Name Pja
NamusUdoxcir icon. o,
Address: O6.
Company:
, Fax: State:
Zip Code' j+ F/j4' Fdx:
Zip: cod
Phone Noo fn)6Hl-%SZG
Address: �r 14, t Rlmd
x,,n IL
City: p..L cn.... L r r'State SL
Zip Code: gUA!vIs 'Fax:
Phone NoCM) R?$-SUOt
E- Mail :.tr J a>iaS ((ZP„L awl-i -
FBI In fee simple Title Holder on next page (ff different
from Me Owner listed above)
EMail
Stat"rCourmyrJ4 7836
. reaunniu.
If Value of HAVC 6 $7,50D or more, a RECORDED NMlo of Ccmmemament Is required.