1986, 08-20 Permit 00012742 InspectSIGNATURE OF
OWNER OR AGENT,
JOB ADDRESS
APPLICATION
DATE i
M U L T T P I... E P F R M I '1`
I. 'inq Code; Fee TOTAL.. FEE
nyrgv Studies Surcharge TOTAL FEE.
KLDING TOTAL FEE
Vo1ua1i.on: Curr 49016
1 f Floors 01 iF of Bedrooms 000 $ ofRoo+lis 006
PIMARY Y TRUGTURE:
DWELLING Gro, R--3 Type: VN
F1 l'188 Occupancy �_.oad R=te 32,00
UiNDART STRUCTURES:
asc; DWl:_KLTNGUB Group: R-3 Typ e: VN
--Ft 1'1SB Occupancy LoadR-atp 6100
: GARAGE: Mout; M-1 Type: VN
`'q -Ft 484 Occupancy �oad ate Sl110
$1,50
$15. 0 0
$4'14,30
Permit Fee 414,50
ilEl.:;i-IMNICAI- TOTAL_ FEE
WENT . Pan 0 Liaap Cooler 0 Hood 0 Duct 0001 M:i.sc 0 Fee
FUEL SOURCE:: Electric Y Gas N Oil N Coal. N Wood N Solar N
1lls:>'PIOUTION: Forced Air Y Radiant N Heat Pump N
LIM,
TOM Fre_
I ...:."?URLS: Bar
Sink
0
Drinking Fount
0 f=loor Drain
0 Fee
C W
Pipe
01
Dish Wlcsher
01 Kitchen Sink
01
Laundry
TY.
0
TT:
ZIP.
02
I_.auatorlu
.PL,C pN T:
0'
Urinal
0 Showa'r
01
CCNTR4CTDR:
ail
Bidet
0 Other
0
OOR E55:
Ga'r'bage D:i.e.posa J
0
rear
CITY:
ST.
ZIP.
PR:
•RCN/CNGINL6R:
OOR[55:
CITY:
ST:
.IP.
AqC CL /:
NTUT TR.
INSPECTOR:
PLPT�:
LOT & nLOCN
001
IIN46
PLAT NAML
20NCs:
NCP58
1
5'Z
RSE
MOO
.1. OP .ERMIT.
17 ADDRL55:
N1
11A'VI
RD
APPLICATION
DATE i
M U L T T P I... E P F R M I '1`
I. 'inq Code; Fee TOTAL.. FEE
nyrgv Studies Surcharge TOTAL FEE.
KLDING TOTAL FEE
Vo1ua1i.on: Curr 49016
1 f Floors 01 iF of Bedrooms 000 $ ofRoo+lis 006
PIMARY Y TRUGTURE:
DWELLING Gro, R--3 Type: VN
F1 l'188 Occupancy �_.oad R=te 32,00
UiNDART STRUCTURES:
asc; DWl:_KLTNGUB Group: R-3 Typ e: VN
--Ft 1'1SB Occupancy LoadR-atp 6100
: GARAGE: Mout; M-1 Type: VN
`'q -Ft 484 Occupancy �oad ate Sl110
$1,50
$15. 0 0
$4'14,30
Permit Fee 414,50
ilEl.:;i-IMNICAI- TOTAL_ FEE
WENT . Pan 0 Liaap Cooler 0 Hood 0 Duct 0001 M:i.sc 0 Fee
FUEL SOURCE:: Electric Y Gas N Oil N Coal. N Wood N Solar N
1lls:>'PIOUTION: Forced Air Y Radiant N Heat Pump N
LIM,
TOM Fre_
I ...:."?URLS: Bar
Sink
0
Drinking Fount
0 f=loor Drain
0 Fee
C W
Pipe
01
Dish Wlcsher
01 Kitchen Sink
01
Laundry
Tray
0
Sewer Eject
01 Water Closet
02
I_.auatorlu
0'
Urinal
0 Showa'r
01
Tuff
ail
Bidet
0 Other
0
Ga'r'bage D:i.e.posa J
0
rear
I. ;enTer
G1. Roof 'D'r'ains. 0
Fee
INSPECTOR'S COPY
$6,30
6,50
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