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SEP-15-98 TUE 11 :02 W; SHERMAN ASSOC FAX NO, 8888888 P, 04 <br /> • <br /> t •`l,'4 <br /> " � <br /> • t ; <br /> Permit No. artr ©( m©uf Nros diirsh5 <br /> ULDM APP_.- O©L1DO[ <br /> Applicant to complete numbered spaces only, <br /> • <br /> SITE ADDRESS <br /> 1 F//' 95Tr.✓do.d / .4- odr/Q - r/ J pe)- q x <br /> OWNER �p /��� m g <br /> MAIL ADDRESS ZIP PHONE m o <br /> 2/r e,74f�C 70-es/As. �iif4srr✓�4 ,I , ,Wiorilars-,2 7,ea-7 '�/�/ m <br /> CONTRACTOR MAIL ADDRESS ZIP PHONE 5:d7 Ss� . , <br /> 3 ' .,fir dcrvol LTi .moo �P , e 41 a*, - /17d�.5-5�.V - <br /> ARCHITECT/DESIGNER/ENGINEER MAIL ADDRESS ZIP PHONE <br /> �sq c14" .45 G o.rry2 A c pre 4_. <br /> ._ <br /> USE OF BUILDING <br /> 4 / �5i,•9e,.f774 4— — S'- -v .- <br /> DESC RIDE <br /> CINN WORK LP <br /> 15 A ,z'f« ,,o, /' m'4Y <br /> -r-t. <br /> Ca5 <br /> - <br /> CQ5pIr\cti)/ <br /> 6 VALUATION OF WORK <br /> ')x5 .3 <br /> . . _ <br /> NOTICE type DI )--;oc oDcupancy IUse <br /> It Group Zone <br /> THE PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION size of — No.of Fre Sprinklers <br /> AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF CONSTRUCTION Bldg. / w i Stones Required Q Yes Li No <br /> OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT (rolal)Sq fia <br /> ANYTIME AFTER WORK IS COMMENCED. OFF STREET PARKING SPACES <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS Wool <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL Dwelling Links Covcrm Unravered <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK THACT BLOCK LOT NO, <br /> WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT.THE Legal <br /> Description <br /> GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW Special Approvals Required Received Not Required <br /> REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION <br /> ZONING <br /> FLOOD PLAIN <br /> SIGNAT R FCO 0 R AUT D AGENT (DATE) WETLAND <br /> �� ',. c/ --:.-:-____14-20 -,ff DR (NAGE REPORT — <br /> G URE OF O NER F OW ER BUILDER) (DATE) • <br /> •� OTHER Moodily) \T.‘ <br /> ' n . <br /> IMPORTANT TO APPLICANT-15tEASE READ ( ,, EASEMENTS D Yes U No piy.r.myth,,,Pr'Ai„q,,,,map) .P• <br /> SPECIAL CONDITIONS - <br /> SEPARATE PERMITS REQUIRED FOR: <br /> - <br /> PLUMBING# C <br /> HEATING, VENTILATING <br /> OR AIR CONDITIONING # <br /> ELECTRICAL# AmorariONAccEPTEO PLANS cHEC f 0 BY APPROVED FOq ISSUANCE ST <br /> :?zt,_1.,44-2-0'crto <br /> BLACKTOPPING # <br /> SEWER# .&WATER# CONTRACTORS LICENSE'/ <br /> STATE .0 NOT REQUIRED O YES 0 PENDING <br /> THIS IS AN APPLICATION ONLY <br /> PERMIT FEE g tg 9..1_5 <br /> THE PERMIT WILL BE ISSUED AFTER <br /> PLAN CHECK FEE <br /> REVIEWAL OF THE APPLICATION. SURCHARGE -.'"'" 6 , g , <br /> SWM CHARGE <br /> LICENSE CHECK S .gym' <br /> TOTAL FEE S '2 n e d <br />