HomeMy WebLinkAboutPermit 107 - Jorgensen Residence - Move ResidenceJorgensen Residence 107
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BUILDING'
PERMIT No.
OWNER
r%o � F
ADDRESS
�s � RD
PHONE
DATE
a �� c'�
BUILDER
ADDRESS
TYPE OF CONSTRUCTION
ARCHITECT
ADDRESS
Y
`
JOB STREET M ER
AD DRESS �Z
USE ZONE LEGAL A LOT SIZE O
N LOT BLOCK
YARDS MAIN SET BACK I SIDE YARD REAR YARD NEAREST ACCESSORY SETBACK SIDE YARD REAR YARD NEAREST
DISTANCETO BUILDING 1
Y t� 6 ✓ / BUILDING BUILDING BUILDING
PROPERTY LINES Ion
GLASS OF WORK X/9v1c 0) n /' -A. A/ /) f JV1 01E/6
REMARKS DESCRIPTION OF ANY WORK NOT COVERED ABOVE
WARNING Notify Building Department by Street Address and Permit Number when ready for inspection. Work must not be
cove before inspection and OK for covering has been given by Inspector in writing on Permit Placard.
I hereby acknowledge that I have read this application and state that the above is correct and I further agree
to comply with all City Ordinances, State Laws, and lawful orders of the Building Inspector governing buildin on-
struction.
Written Authorization of the owner must be pre- C
sented when work is done by occupant or lessor. OWNE x
PERMIT FEES (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY) (
HOUSEBc ) — OTHER MISC.
HOUSES G ARAGES ^- ARAGE i BUILDINGS III—FEES f
��Q� RECEIVED PERMIT
—.
BOND NO. TOTAL FEES i�GSi -�—BY �. BY�DATE�L.'G�(' !L_
NOTICE THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THE WORK
MAIN
WIDTH
DEPTH
AREA
TYPE OF CONSTRUCTION
BUILDING
Y
`
—_
SIZE
FT. �
FT. SQ, FT.
OF
6:
BUILDING
ACCESSORY
BUILDING
WIDTH
oEpTFI
FT. X
AREA
—_
FT. eq, FT.
rM 14
EXISTING BUILDING AREA---- - ----
SO. FT,
TOTAL AREA OCCUPIED
LOT AREA
LOT AREA OCCUPIED
LOT COVERAGE
SQ, FT.
So. FT.
EXTERIOR
FINISH
OCCUPANCY
I TO BE USED
HOW
BASEMENT
AS
HEATED
SIZE SQ, FT.
ROOMS
TOTAL
BED
ROOMS
BATHS
LIVING
L -D
COMBO
DEN
KITCHEN
NOOK
K•D
NOOK
ATT.
GARAGE DET,
❑
❑
—
C 6^ 3
VALUATION OF
HOE
f
RAGE f
HOUSE - ATT. GARAGE i
T
THER i
ALLIMPROVEMENTS
FOUNDATION OK
FRAMING OK
FINAL INSPECTION
REMARKS DESCRIPTION OF ANY WORK NOT COVERED ABOVE
WARNING Notify Building Department by Street Address and Permit Number when ready for inspection. Work must not be
cove before inspection and OK for covering has been given by Inspector in writing on Permit Placard.
I hereby acknowledge that I have read this application and state that the above is correct and I further agree
to comply with all City Ordinances, State Laws, and lawful orders of the Building Inspector governing buildin on-
struction.
Written Authorization of the owner must be pre- C
sented when work is done by occupant or lessor. OWNE x
PERMIT FEES (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY) (
HOUSEBc ) — OTHER MISC.
HOUSES G ARAGES ^- ARAGE i BUILDINGS III—FEES f
��Q� RECEIVED PERMIT
—.
BOND NO. TOTAL FEES i�GSi -�—BY �. BY�DATE�L.'G�(' !L_
NOTICE THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THE WORK