Permits - Permit# 94-09 - 2478 Black Lake Road - 1/1/1994CITY`OF SPRING PARK
BUILDING. PERMIT APPLICATION
Building Permit Application Requirements:
1. Application to be filled out & signed
2. Mechanical Permit Application & Calculation filled out
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 Sets of Construction Plans
a. 1 set for City files
b. 1 set for builder to use on site
c. 1 set for city Building Inspector
Construction Plans should include:
1. First floor plan
2. Footing & foundation plan
3. Elevations of all sides
4. Wall sections & cross sections
5. Details - stairs & any special connections
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS: (Circle One)
JOB SITE ADDRESS:
Date Received:
Date Approved:
Permit No.:
Fees To Be Charged:
Permit $ /G-Ov
State Surcharge —4/5-0
Plan Review -
SAC Charge
Availability Chrg -
TOTAL_ $ /9�2.15-0
NAME OF OWNER: /]� AIM sw�.uj-e- HOME PHONE WORK PHONE f &� e 7 Sa 0
MAILING ADDRESS 2 CITY SOS N c �A��L ZIP
CONTRACTOR iVi_ , 91, 6a ! w PHONE % 3 3 - 7 % 'j .3
MAILING ADDRESS /� a ' /� /v . CITY _ ZIP 57" -36S
STATE LICENSE NO. 63d 9 (o
ARCHITECT/ENGINEER
NAME
PHONE
CITY
REGISTRATION NO.
ZIP
TYPE OF WORK: New Addition Accessory Structure Move Demo
e A teration Renovate Land Alteration
PROPOSED WORK (Describe in Detail)
ZONING DISTRICT
STORIES
SQ. FEET OF EACH FLOOR
STALLS ATT. OR DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) $
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CITY QF SPRING PARK
BUILDING PERMIT APPLICATION
Page 2
HARDCOVER CALCULATION WORKSHEET
A. House X =
Length Width
X =
B.
Garage
C.
Driveway
D.
Sidewalk
E.
Patio/
Deck
F.
Other
1. TOTAL. HARDCOVER
2. TOTAL PROPERTY AREA
1 : 2.
X 100 =
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
I hereby apply for a building permit and I acknowledge that the information above is carQlete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with the
State Building Code; that I understand.this is not a permitand work is not to start without a permit;
and that the work will be in cord ce.with the approved plan.
APPLICANT'S SIGNATURE LIP
DATE
INSPECTION REQUIRED:
Footing before a pour
Framing rough -in.
Insulation -
Wallboard before Taping
FINAL before occupancy
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO
PENALTY.
24 HOUR NOTICE REQUIRED
473-7357
WOW REQUIRING SEPARATE PS NIITS
Plumbing
Mechanical
Well.
Grading.__&.Filling
Sewer
Water
Electrical from -State
BUILDING INSPECTOR DATE
�4
i 6.10m) Uluetian $96000,00' Millar DavisCo.,MCd!(ae•��
ik.k ir�, ' �:50
..._..__
County, o£,1'[]1�iit::.:.:�.__... ___............. _.
.........................--
_.....C11.F.'...._..:..._.of...:.....�µ� :1su� ..a i 1C ................ _.....
......
Office of ........ ................ _......_
lbin ermit
W.jBuig
IN CONSIDERATION. OF The statements and representations made by......._._ .... _.... _...... _.................................... _...-.
3 N 1S1�! fr" 1 � ...i��tiliK1de1I jig fro.•-m-Patri ck...KBIly.._..... _......._...._...__...........__.._....._---------------------------
'. itL. +...:_�:_.. application therefor duly filed in. th"77is office, which application is hereby made a part hereof, PERMISSION IS HEREBY
r-....._._.._._.._....._.....____._....._._......as owner.
GRATTTED. To said._ ....... .._... . i .... I .1• •_ n - _
a building described as follows: kind of construction
Gt►11.t�L...+1iA6c..F.3xti-'8s...fdate�••Cl-F]�� g
. (build;,etect,.instan, add't% alter, repair, move Wreck. as the ease may )
__ ...........:._......._........___....._._...._-..._�_._.._..._.............. ....._...._.........__..._........__--__.._...._._......... _.......... ---
fto or width is feet^______.._..__..........___........ side or length in feet.._._.....__......._......._....._..___; height in feet..___ ------- _ ----- _--- _-------- ,._...._._._;
feet; __......._..___.....__........___square feet, upon that
number of stories......-_.._.__._..__.__.........; _..___.._.._.._.-.-.....�
tract~ of; land described. as. follows:. Lot...... _.___..�._.__.._...Block_.. ____.....__.__ .....___._.....; plat or addition. ....... __._.................................... _._
ys48_.k..1,.1 ........... ..... ............ ___.... _.........
._.._....................................._...
st�....._���.
w.hi& tract is of the size, and area specified in said application. gents, workers and employees, shall
permit , i"s, granted upon the- express conditions that said owner and h___ contractors, a
s:of the_ City _..__..._._ S rir� Pa)~I:
ccmp. in -'all' respects. with the, ordinance ...._ ..-.........-.-._.of..._....i?_..___......__...._...........__._...........; that it does
ly.
riot, cover the use of public property,. such as streets, sidewalks, alleys, etc., for which special permits must be secured; and that it does
not cover the following: ...._.__._..11sltl..iix I.11...sc+1.iciWigp....._...—..--._....—•__.__._...._...._........_....__....____._..__..........._._...._.........._...............
t (Eecukyl work, plumbW, hating, pluterlug, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the.... ��.d.?► ��11skI...:10Ei�s»s:�,]r _._..__.__......of said_ ice_._... —_.._._............_...._......and its corporate seal and
Clerk ' _this._i1:tt ........_.__......day o£_.jrlill_.........__....._--.._.-_.,__................._.....19_�_
attested by its __�.._....._.....___...____._
A �;.
_� J Cicr1�.._........_._...._..__ M �.. _......._ BU i 1 d LU_I,;;:r;ti:.�.........__...._