1986, 01-08 Permit App: 00009345 Fire Damage Repair(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
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Architect/Engineer
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City
State
Zip
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Business Phone
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Lender
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R/W Width
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BUILDING INFORMATION _ _
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Number of Bedrooms
Croup
Type
Show on Site Plan:
Additional Information:
Lot Dimensions
Landscaping
Existing Structures
Proposed Improvements
Drainage Plan
Hydrants
Siructure Setbacks
Topography
111
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Easements
Septic System (s)
Water Lines
Lighting
Signage
Shorelines
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Sewer Lines
Fences, Wells
Highwater Mark
Driveway(s)
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Hight of Way Width(s)
Names of
Fronting Street
Flanking Street
Legal Description
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Scale:
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Date:
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