HomeMy WebLinkAbout3830 Pierce Streeti CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: k�' � 1 � `'fy) y
Job Address: e. r
Permit Number:
❑ No one available for inspection: Time` AM/PM
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
hUp✓/www.ci. whea tridge. co. usfinspection
Date: � i \ \� f Inspector:
DO NOT REMOVE THIS NOTICE
A i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
r
Inspection Type: "� , ' `� "I `` � �L,
Job Address: 3 b 7.- y V� ! e..r
Permit Number:%
❑ No one available for inspection: Time `_ AM/PM
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
http://www. ci. wheatridge. co. uslinspection
Date:_ 6 \ V� Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:
Job Address:
Permit Number: C ! 1
0 ,, � 1 1,-
r
❑ No one available for inspection: Time `' AM/PM
Re -Inspection required: Yes No
When corrections have been made, schedule for re -inspection online at:
http://www. ci. wheatridge. co. uslinspection
Date: t) *� U ' 6 Inspector: -)k
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Plumbing PERMIT - 201902133
PERMIT NO: 201902133 ISSUED:
JOB ADDRESS: 3830 Pierce St EXPIRES:
JOB DESCRIPTION: Repairing up to 20 feet of gas line
*** CONTACTS ***
OWNER (720)949-5446 MOROLES MARIAM
SUB (720)296-7972 TREVOR HARVEY
10/08/2019
10/07/2020
130129 AFFORD A ROOTER
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: UA / Unassigned BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 600.00
FEES
Total Valuation 0.00
Use Tax 12.60
Permit Fee 29.90
** TOTAL ** 42.50
*** COMMENTS ***
*** CONDITIONS ***
All work shall comply 2012 International Codes, 2017 NEC (if applicable), and ordinances
adopted by the City of Wheat Ridge. Work is subject to field inspections.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications:
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perforin the work described and approved in conjunction with
this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
pe Iirm" e j and that all work to be performed is disclosed in this document and/or'' s' accompanying approved plans and specifications.
Signature or- OWNER or CONTRACTOR (Circle one) Date /
1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a pe shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code ordinance egulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
W heat Ildge
CommuN TI' DEVELOPMLN 1
Building & Inspection Services
7500 W. 29' Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(o1ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date: l o j1
Plan/Permit #
(u N 0 011JI 33
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address.
3�3e) ��,PcCe 3+�4
Property Owner (please print): i`C1oC', () M ► l tb ;G
Property Owner Email:
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer:
Architect/Engineer E-mail:
Contractor Name: n 9�A-
TQ<
City of Wheat Ridge License #:
Contractor E-mail Address: Q
on a ob het 9 q Q
Phone:
Phone:(
76-0'�1-1l 5qq &
Phone:( 7�12) D-q4P-797,'
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): Phone o,6�-(7(v -7c? 76
CONTACT EMAIL(p/ease print) . � � 4 (eb �e e Q M e"
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields.
❑COMMERCIALRESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, ty a and amount of materials to be used, etc.
J
Sq. FULF
BTUs
Gallons
Amps Squares For Solar: Kw # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) CC
Signature (first and last name):
Printed Name:
ZONING COMMMENTS:
Reviewer
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
or (A I�TINRIZED REPRESENTATIVE)
DEPARTMENT USE ONLY
of (OWNER) (CON RACTOR)
DATE: ld q
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
I
R.
I
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:i °' �' �•\� n°���
Job Address: 7` L) e \ e_ c Q_ 4 i -
Permit Number: OC) k C'1 L -) t �"',
❑ No one available for inspection: Time AM/PM
Re -Inspection required: (Yes No
When corrections have been made, schedule for re -inspection online at:
http://www. ci. wheatridge.co. uslinspection
Date
Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type:i °' �' �•\� n°���
Job Address: 7` L) e \ e_ c Q_ 4 i -
Permit Number: OC) k C'1 L -) t �"',
❑ No one available for inspection: Time AM/PM
Re -Inspection required: (Yes No
When corrections have been made, schedule for re -inspection online at:
http://www. ci. wheatridge.co. uslinspection
Date
Inspector:
DO NOT REMOVE THIS NOTICE
• I
Property ner Email:
Mailing dressy (if different than property address)
Address:
Ciy, State, Zi
A
Arch tectlEngin ;. r E-mail:
rre:
Contractor.
- 7 - to 3so 6 116
Contractors, City License*
Phone:
Contractor E a 1,Address:
Sub Contractors:
Electrical: Plumbing:
Mechanical:
W.R. City License # WR City License #
W.F. City License
Other City Licensed Sub:
tither City Licensed Sub:
City License #
City License
Complete all information on BOTH[ sides of this foram
MI
#
303-341-73•4 p,4
Property Address:
Property Owner Email:
1,111! Q L431
I
Architect/Engineer E-mail: Phone:
i
Contractor E-mail Address:
Plumbing:
W, R. City License #
/74�57
1, •
mmm�
Naim
Complete oil information on BOTH sides of this form
i- r s r' r „r•
C
0 NEW COMME r . ELECT a. UPGRA
i
NEW RE STRUCTURE COMMER R OOFING
C OMMERCIAL AD DITION RESIDENTIAL R OOFING
RESI DENTIAL RESDENTIAL ADDITION WINDOW REPLACEMENT
COMMEMAL ACCESSORY STRUCTURE (Garage, shed ' deck, ate.)
ZE
. .r- shed de
MECHANICAL $YSTEMIAPPLIANCE REPAIR or RE
P LUMBING SYSTEW REPAIR REP LACMENT
' OTHER ELECTRICAL SYSTEWAPPLIANCE REPr1RJ REPLACEMENT
P sct
l ♦ ♦. i:w «. � • . r:. e" :: s w « r r. ♦ r • w: «. ,�. .a. r ^� !^M. x «.,
• •lM -w, ♦ ,. 4• .r- •. s • • • .. IY. R ilM "• • !: •: «f • IF° i •. •' � «.
am ount of • be used
x
Z-19M
Amps
sues
qua
EM
Pro3 t Value. (Contract value or ft cost of 11ilmaterials and labor induded in the tir project)
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r
PROOF PI~ §U8MIS3I FORM§
Fi re D# partrriert Received Not Required
3
Waforolshia Re.�md Not Required
a Die C] Rei:e ivatJ Not Required Building Division Valuation:
/38'0 Pierce Strcet
2014015151 1401516
, ^' a1e. red inn cOnitnents tra r erncrara u
lh plan,, )
W ork haall comply with the
folio-wing crar es- 2006 11 .,
2006 [EC(,& 2 011 NEC
S moke alarms are uire to
,4 t
be ded in the bedrrrrrrra
area outside the edroam an
all level. Hard Nv rr ed and
head Ridge BuHding D epartmen t
interconnected.
App roved
C arbon raa noxirl d ete c t rr
r Prlarr 3 3'
R #5G OF F I C IAL &., d
B UI LD I N G g p g [
bedrooms
Validity of permit The issuance of a p evrd or approval o plans, specifications
arad" i t"�PtlaPfarlCaS$` sha not be t }�`�` rg a fr`ce "f atJ a;b°�afCta,°a CFf< ra lr3a& s "ta
lrafa r aft 1 kR and permit rrrr i r
an , 'af o,; ar ,morns of o s , � , z .x e or of my C ity rafirlinan es
k itchen cabinet replacement, ,
ea ata orp"" ��a � �+ =�t.' , , � � �a ;�� �r
installation of e kitchen
s ink and additional smoke
laarrrar` aarwlarara monoxid
detection only. Any further
remodel of the kitchen is
beyond the arenas of this..
x
r"rr
rf PROVED
i k t£ xs peQ,a3!k„a"Rk
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COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 18058
BUILDING INSPECTION LINE -(303-234-5983) Date : 11/12/2004
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner: DONNA DIENES
Property Address : 3830 PIERCE ST
Contractor License No. : 17152
Phone : 423-6373
Company : Precise Plumbing Phone : 534 0881
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate, and
do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenanls, easements or restrictions of record; that all measurements shown, and allegalions
made are accurale; that I have read and agree to abide by all conditions printed on this
application, and that I assume full responsibiliry for compliance with the Wheat Rid9e Building
Code (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this pertnit.
(OW NER)(CONTRACTOR)
Valuation :
$480.00
Permit Fee :
$30.55
Plan Review Fee :
$0.00
Use Tax :
$0.00
Total:
$30.55
Use:
Description : REPLACE WATER HEATER
AM
z6Ili11d COt11R16fItS:'
Approval :
Zoning :
Bulkiing Commenf
Approval :
Approval :
BUILDING DEPARTMENT USE ONLY
SIC : Sq. Ft. :
Occupancy : Walis : Roof : Stories : Residential Units :
Electrical License No :
Company:
Expiration Date :
Approval :
Plumbing License No :
Company:
Expiration Date :
Approval:
Mechanical License No :
Company:
Expiration Date :
Approval:
(i) This permit was issued in accordance with the provisions set forth in yopur application and is subjecl to the laws of the Stale of Colorado antl to the Zoning
Regulations and Builtling Code of Wheat Ridge, Coloretlo or any other applicable ordinances of the Ciry.
(2) This permit shall ezpire if (A) the work authorized is not commenced within siuty (80) days from issue data or (B) the building authorized is suspended or
abandoned for a period of 720 days.
(3) If lhis permit expires, a new permit may be acquired for a fne of one-half the amount normaly required, provided no changes have been or will be made in the
original plans and specifcations and any suspension or abandonment has not exceeaetl one (1) year. If changes are made or if suspension or abantlonment
ezceeds one (1) year, full fees shall be paid for a new permit.
(6) No work of any manner shall be done that will change the natural Oow of water causing a drainage Dmblem.
(5) Contrector shall notiry the Building Inspector hventy-four (24) hours in advance for all inspeclions and shall receive written approval on inspeclion card betore
proceediin 4 successive hasesofthejob.
(6) T"4 f a vnro-r the appro f tlrawings and specifcations shall not be wnstmed ro be a permit for, nor an approval of, any violation of the
t ildin ocodqs ordinance, law, rule or regulation.
~
Chief Building Inspector
Please sign Terms and Conditions on reverse side of page.
DEPARTMENT OF PLANNING AND DEVELOPMENT Buildittg Peimit Number:
BUILDING IN5PECTION LINE - 303-234-5933 Date:
C1TY OF WHEAT RIDGE
7500 WE5T 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2555)
~~~~~~OiY
Property Owner: 0on-'4 r:
Proper[y Address: 3 Y' 3 p /0 %Pi' c e 5 E Phone : H 7~'l -C 3'~ b
Contractor License No.: / 17 / s' :2.
ComPanY Poe c i s c Pl, `L y -Tn c Phone: 4-3 0 fS" R-/
O WN&R/CONTRACTOR SIGNATUR& OF UND6RSTANDING AND AGR6&MENT
I heazby ceAify that the satbsck diatmcos proposed by Utis pemut applicatioa ere
accurata, and do not violate epplionble ordinancen, niles or regulatiom of the City
of Wheat Ridga or covanantv, eesammGs or restrictiona of reoord; thd dl
r... mensuremads shown, md allogations made ve ecciuatq t6at I 6ave read aad
agx to abide by alI conditions priakd on tlvs applioations aad 1Lat I easume ful(
responsibility for complia¢ce with ihe Wheet Ridge Build'vig Code (U.B.C) md
all othar appiicable Wheat Ridge Otdinmces, for wotk mderthis pvmit
(oWNffiRXCON'IRnCfOR): s16NEQ,i~~~~~TB
Description:
,,p~[E
/•'r
Construction Value: i/ 8'0 ^
Permit Fee: 30,T57
-
Plan Review Fee:
TTaa Tar• .S.r.a,. c Y'vv %C
Total: 3 O, 5- 5-
Electrical License No: Plumbing License No: Mechanical License No:
Company: Company: Company:
Expiration Date: Expiration Date: Expiration Date:
Approval:, Apprwal: Approval:
(1) Tius pemut wu iseued in acco[deoce witlt Nu proviaione set forth in yow applica4m md 'u mbjxl to the lawe of the S4te ot Colondo and k the ZoNg
Regulatiov md Btilding Code aC Whut Ridgq Colondo ar my oNa qvlicable oNwncv of Uu Ciry.
(2) '[fiis pemtiL shell mryae S(A) the wo[k suthocized'u mt commmced within aixty (60) drys ffom iuue daw or (B) the btildiog authocized a suaPmdad or
ebandonad for aperiod of 120 dryi.
(3) if this pemit mxpum, e nmv pemit may be ecquiced fm a tee oC ono-half the unount nomWly required, providad no changm heve been or will be mnde in
the onginal Pleoa md apecifiutimu md my au+pmaion m abmdwmmtEu noL mcce¢ded one (1) yaer. I(chengm Iwe been w itauspwiort w abaMomnent
mcceeds om (1) yarc, fld] faa ilull bepsid for a new Pmnit
(4) Noworkotanymmn¢shellbedonetLatwiLLeLmp themGUelflowotwakrcausinga dcsimgepioblem
(5) Contactox shellmtify Ne Btilding Inspector twwrydmu (24) hom in advmce fa &Il impations and xhsll i«eive wnaen epp[wat on inapection cud before
proca>dinBwithauccassivephua oCiheJob.
(6) ILe iseuance of a pemiiL or the apprwal of dnwinga md apauGca4om ilull rot be comhued m he e pewit fw, nor en +pptoval of, e¢y violaaon of th¢
p[ovieioas oftlu btildiog codm ar e¢y ofher otdimnc4 Lw, nile orroBUlaCOO.
If
Chief Building Inspector
~ DEPARTMENT OF PLANNING AND DEVELOPMENT
BUILDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80275 - (303-235-2855)
Building Permit Number : 11335
Date : 10/16/2000
Property Owner :
Property Address : 3830 PIERCE ST Phone : 423-6373
Contractor License No. : 18464
Company : B& F Heating & A/C Phone : 431 8914
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certiy that the setback distances proposed by this pertnit application are accurate,
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or restrictions of record; that all measurements shown, and allegations
made are accurate; that 1 have read and agree to abide bY all wnditions printed on this
application, and that I assume full responsibilily for comPliance with the Wheat Ridge Buiiding
Code (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this pertnit.
(OWNER)(CONTRACTOR) SIGNED DATE
ConstrucNon Value :
$1,700.00
Permit Fee :
$60.10
Plan Review Fee :
$0.00
Use Tax :
$0.00
Total:
$60.10
Use:
Description : REPLACE 75,000 BTU FURNACE
Electrical License No :
Company :
Expiration Date :
Approval:
Plumbing License No :
Company:
Expiration Date :
Approval :
Mechanical License No :
Company :
Expiration Date :
Approval :
(1) This pertnit was issued in accordance with Me provisions set forth in yopur applicetbn and la wblect lo the lews oi Me State of Coloratlo and to the Zoning
Regulations and Buildina Cade of VJheal Ridge, Colorado or any other applitable ordinances of Ae Cily.
(2) Tliis permil shall ezpire rt(A) the woAc authwizetl Is not commenced within sixry (80) days trom issue date or (B) the buildinp authonzetl is susperWetl or
abantloned tor a period of 120 days.
(3) If this permit expires, a new pertnd may be acquired for a fee of one-half ttie emount nortnally required, provided no changes have been or will be made in the
original plans and specificatlons and any suspension or abarWonment has not ezceeded one (1) year. If changes are maEe or d suspension or abandonmeM
exceeds one (1) year, (ull fees shall be paitl for a newpa rmR.
(4) No work of any manner shall be dane that will change ihe naturel flow of water causinp a dreinage problem.
(5) Contractor shall notiry the Builtling Inspec[or Wenty-four (24) houre in a0vance for all inspections and shall receive wntten approval on inspectlon card before
praceetliing with successrve phasea of the Iob.
(8) 7 ance W a it or the approval of drawings and specifica6ons shall not be conaWed W he a permit for, nor an approval M, any vidation of the provisions
I~ ~ ildjp/ or any other ortlinance, law, rule or regulatlon.
nspector
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION dIVISION - 235-2855
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 APPLICATlo N
PropertyOwner:_Dbhnq IJ4;,-i-sa
Property Address : ~3U P', e,-c'j:a4- Phone
Contrector License No. : 16,A (D4
Company :'6, -~7
ONRJER/CONTRACTOR SIGNATURE OF
Phone:y31-?~3/`J-
ANDAGREEMENT
I hereby certify that the xtbaek distanees proposed by this pertn8 application aro accurote,
and do not violate applicable ordinances, ruks or regulations of the City of Wheat R(dge or
covenants, easemenb or rostriotions of rowrd; that all measurements shown, and allegations
made arc accurate; that I have read and ayrce to abide by all conditions printed on this
appliptlon, and that I assume tull responsibility for compliance wtth the 1Nheat Ridge Buildiny
Code (U.B.C.) and all other applipble Whe~a~t Ridge orclinanas, for work under this pertnd.
(OWNER)(CONTRACTOR) SIGNED c~ i a-~A _f1Ol,' LA pqTE lc 13lOD
Description :P,~_ ~~y~~ , ~ Q~.~ ~ ~
SIC : Sq. FL :
I Occupancy : Wails : Roof : Stories : Residential Units :
ElecUical License No : Plumbing License No : Mechanical License No :
Company: Company: Company:
Expiration Date : Expiration Date : Expiration Date :
Approval : Approval : Approval : was
Wued (1) RTtft e9ulstloPwn*nt and BuI1N mCO~tla ~W Y~Mast R~itlpa~~a set fiM in yopur applieation and fa auOjeU fo Me Wva M the Sfata M Cobratlo and to Iha Zoninp
(2) Th~ ~p . CobraEO or a oMer appliea0le orEinances M tM Cly.
abentlonaE for a psr~wtl~of~i~Yitls rywaak autlanzaE ia not oommenced wiNin aizty (eo) tlays hom isaue tleta a(B) tM DuiWfny BuMOAZeE ia auspantla0 a
(3) If Mia P~k w0~. a Mw pemYt mry ba uqWrad for a fee of ono-hatt ihe amount rrortnally repuirM. 0mviEad no cMnOn Mva Dsen a wfll be matls In tlie
~s au a on (1) yiur.ih ~ W b ms~sbn or absntlonmeM haa not azceeCetl one (t) Yeer. M Wnpas a~a mada a X auspansion a aE~nOOnrtiaM
(0) No Wdk Of P~ fOr a naW pemYt
ury mkrmer WN N tlona that w111 Uanpa the natuial Ilow ol water auafng a drainage probbm
(5) Canv+cwr aUi nonN u+a euiweq insp~ror M~anly'four (24) hours in adwnee for all inspncfions and alull receiua vrtNten approval pn inspsctirn nN DeNrs
Onancaatli4q wrm wcaaWa DAa~aa ot Msp' b
~ nsu~nc
(B) s of a parmit a tlia appiwal of 4awinps and speeifirations shalt rat be oonatruetl m De a pamik tor, nor an appiwal of, arry violetion uf yN qwiaiaro
of tM Ouqd6q ooOSS a my othx aCinarce, lew, rule a requlatbn.
Chief BuNding InspecWr
P~Tu ~W_LVNLk_!Z~
Construction Value : 1--+oo
Permit Fee : (oU . I o
Use Tax : ~
Total :
use:
BUILDING DEPARTMENT USE ONLY