HomeMy WebLinkAboutPermit 176 - Erickson Residence - Additionearl Erickson Addition
OW ER
ADDRESS
PHONE
DATE
BUILDER
ADDRESS
TYPE OF CONSTRUCTION
ARCHITECT
ADDRESS
FT. "
F7. � BQ. PT.
JOB
ADDRESS
STREET I i NUMBER P
/ rLL
USE ZONE
LEGAL 6 Nom/ T U G IC (/1// 419
LOT BIZE
L OT ARE
LOT
BLOCK
YARDS
DISTANCE TO
PROPERTY LINES
MAIN
BUILDING
SET BACK
SIDE YARD
REAR YARD
NEAREST
BUILDING
ACCESSORY
BUILDING
SET BACK
SIDE YARD
REAR YARD
NEAREST
BUILDING
CLASS OF WORK 9 /71 /) 1 — /) /9 /\ / 7 ) I: . L A/7 )-h . AA !=
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
co vered 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 building con-
struction. /21-L4 I,
Written Authorization of the owner must be pre-
sented when work is done by occupant or lessor OWNER A rl /Vi 1 - C k S e d BT x
PERMIT FEES: (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY)
r y 0 O V HOUSE Q OTHER MISC.
HOUSE - 2 G ARAGE S G ARAGE S BUILDINGS: FEES S
16 RECEIY PER
BOND NO.— TOTAL FEES t BY
NOTICE: THIS PERMIT DOES NOT COVER PLUMBING. SEWER. OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THEVORK
MAIN
BUILDING
WIDTH
DEPTH
�(
AREA
_
TYPE OF CONSTRUCTION
FT. "
F7. � BQ. PT.
SIZE
ACCESSORY
BUILDING
WIDTH
�( DEPTH
FT. X
AREA
FT. '"' SQ. FT.
OF
BUILDING
fffQ
/ /
!`
EXISTING BUILDING AREA----------- ---
SQ. FT.
TOTAL AREA OCCUPIED
LOT AREA
LOT AREA OCCUPIED
LOT COVERAGE
_
SO. FT. '
SQ. FT.
/Q
EXTERIOR
FINISH
OCCUPANCY
TO BE USED
AS
` Iv
HOW
HEATED
BASEMENT
SIZE - ^_ SQ. FT,
ROOMS
TOTAL
BED
ROOMS
BATHS
LIVING
L -D
COMBO
DEN
KITCHEN
NOOK
K -D
NOOK
ATT. ❑
GARAGE DET. []
VALUATION OF
HOUSE i
V
'^—
GARAGE S
HOUSE - ATT. GARAGE S
OTHER S
ALLIMPROVEMENT9
Q (l
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
co vered 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 building con-
struction. /21-L4 I,
Written Authorization of the owner must be pre-
sented when work is done by occupant or lessor OWNER A rl /Vi 1 - C k S e d BT x
PERMIT FEES: (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY)
r y 0 O V HOUSE Q OTHER MISC.
HOUSE - 2 G ARAGE S G ARAGE S BUILDINGS: FEES S
16 RECEIY PER
BOND NO.— TOTAL FEES t BY
NOTICE: THIS PERMIT DOES NOT COVER PLUMBING. SEWER. OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THEVORK
floor plan
inspectors daily report
sewer inspectors checklist
harstad associates