HomeMy WebLinkAbout2802 STATE ST; ; 74-644; PermitApplicant to complete numbered spaces only. ,Phone 7 29-1181 Permit No.
Joe AOOACSS .?St1 y/11 "/L .... )-f, ASSESSOR'S
PARCEL NUMBER
LOT NO. I OLK I r.ACT BOOK PAGE I PA.R.
LEGAL I (□set. ATTACHED SHCET> 1 ocsc •.
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CONT"ACTOR MAIL AOOA [SS PHONE LICENSE NO. STATE CITY
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A,_CHITCCT 0 111: OCSIGNCIII M,._IL ADOACSS PHON t LICCNSC NO.
4
ENG IN CC A MAIL AOOACSS PHONE LICE.NS£ NO.
5
COMPENSATION INS. CARRI ER MAIL AOOR CSS 8111:ANCH
6
USC 0,. BUILDING
7
8 Class of work: 0 NEW )( ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: '-/5' r>f t'' Block Ten<e 5' /1 11 J/,cjh
~f
10 Change of use from
Change of use to
11 Valuation of work: $ ;JS0,0--0 I' I PERMIT FEE $ ..s ~c
PLAN CHECK FEE$ --
SPECIAL CONDITIONS: MICRO FILM FEE Type of Occupancy
Const. Group
./ .I Size of Bldg. No. of M a~.
-"S £~, I (Total) SQ. Ft. Stories 0cc. Load
✓/ J(.,,//'f F ire use Fire Sprinklers
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISStnlNCE l!v Zone Zone Required 0 Yes □No
~ No. of OFFSTREET PARKING SPACES:
/ .... )( -A Dwelling Units No. 'No. DATE DATE Covered Sq. Ft. Open
NOTICE Special Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB· PLANNING DEPT.
ING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL ANO VOID I F WORK OR CONSTRUC·
TION AUTHORIZED IS NOT COMMENCED WI THIN 120DAYS, OR IF FIRE DEPT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY T IME AFTER WORK IS COM· OTHER (Specify) MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT.
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL L AW REGULATING CONSTRUCTIO N OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATU~ o, CONT"A<'fO• DA A7.IZCD AGE/ (DAT£1
?1~1111 /.,,.,..,__, ')L. J JIT"> t. O'
•-=N,\TU"'I. 01" OWNtfll 1, OWNtfll BUILD£") , ln.'11.TE) . WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M .O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR