1994, 11-17 Permit App: 94011496 Safety InspectionAPPLICATION INFORMATION
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SITE ADDRESS ,, 14- 0-• -1
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Legal description
Zone r 5
Inspector district
Property size
Right of.way width 67
Water di n
OWNER ,,� r nn
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AddressCity,
6. ill f
state Zip
(1, i 11' 141
APPLICANT Phone
Address ,% Oil, (I ( -j � (/y /1 /1, City, state Zip
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CONTACT Phone EktSTi ,. `& bed<
PERMIT USE D ,/
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114k-) ki Aai_A it l' 17C I
Building
New C ange of use
Add Remodel
(ding height
Stories
Contractor
Dimensions
Total square footage
License
Main floor
Unfinished basement
Address
Second -floor
Finished basement
Architect/Engineer
'-arage
Decks, etc.
Value
Manufactured Home
Sign
Width:
Length:
Square footage
Height
Year:
Make:
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip
Relocation
Fire Safety
Previous address
Fire Sprinkler Tent _
_
Paint booth Fire Alarm Fireworks display
_
VALUE
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip
Fuel Storage Tanks
(Circle one) Above -ground Underground
Swimming Pool
Contents
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
License
License
Address
Address
City, state, zip
City, state, zip