HomeMy WebLinkAboutRS070116_Application - QuestionaireRDMO/Development Processing Center Pe.mrc N
0 BUILDING PERMIT QUESTIONNAIRE K W 701 /
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VPE OF PERMIT: MRESIDENTIAL IRS) ❑ COMMERCIAL(NR)
❑ SWIMMING POOLISPA (SWISA)- ALSO NEED TO FILL CUT OUC87ONNAIRE
❑ ELECTRICAL ❑ MECHANICAL
❑ PLUMBING ❑ Non -Structural (EL, PB, ME, Combo)
El RETAINING WALL- SEPARATE ATTACHMENT REQUIRED FOR MULTIPLE WALL SURNAT AL
Building Adareeed Pmlect II Ad AL6o \l hiw PO.T �PYr CAL
Neam$t Cmas StMM! N P ? V 1 'i £ k '�PD
Owner ram: (AYA V eT� ilriJ lL
ITArser Aadraes ovrl to Nhfc. uc.avnr arnw ra 4zki
Contractor. cmnnul bes 36•
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Crantact Person: ' cy M
- AlAllatlan: £nPU YfL
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STRUCTURE SIZE:
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GARAGE SIZE SQUARE FEET
SITE ACREAGE
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ENGINEER: KNSF croc,I
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STAFF USE
ZONING:
SETBACKS
APNe'.
ACTUAL REO'D
LEGAL
FRONT
PA.
SIDE
REAR
ACCESSORY STRUCTURES
LOT COVERAGE
DECLARATION:
I declare that its foregoing Is a true and correct to the past of my knowledge. I underhand that an'mcorrad answer will cause
delay to Inspection approval and issuance of a stop work Order.
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Prim name
Slenature Date