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TOTAL .
FEE
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INSPECTORS COPY
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'FORM 284-208 284-208.(281) a
.,�•.
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slob Grade
35
Furnace Comport.
3
Steel
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. E]
43
Final
10A
Fireplace T. 0.
°o
ADDITIONAL INFORMATION
'
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Botts) ---
12C Ceiling (Blown)
14 Final
15 Ground Plumb
16 Water Piping
17• Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test a
25 Final
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
a P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
298 Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
'MiigPrM�gp��Tyy/�M; i�77���r)��}y�y4�►�D113�+ ,
DATE
A `V vol o 021523
FEE $721zo
CACOONAlr4 E/ZIP ,.,A 122510000
22510000
@LT DRESS/SPACE AVE MONTEZUMA
p
cwC0UvlwyAx/ZIP �� 922530000
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nlor IX COUNTY
CONTRACTOR -FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE #
LICNC #
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE 4
LICNC #
BUXL NO ? PERMIT 1A I
AKA ITRAMABA IN CIVIC CKNTE'N PK
410
t, .0
tf?pa
0FI{B0
#V0
Q V
(M
ND
ZONE ORD #
LOT SZ
END
SIDE
KP `J'MR q V J
C006TRUCTION
DATE
A `V vol o 021523
FEE $721zo
ADD P/C FEE
Sml Ke
HICROVIL" FEE
W.64
1•
1
I
STRUCTURAL
BUXL NO ? PERMIT 1A I
TOTAL
t, .0
IIVJYtI.I VK'J C.VYT
TOTAL PERMIT COST ;CS
CONSTRUCTI N 011MATF. (NOTEi Not to be overt os prop rly► v lluation)
acr ptien FCC Cr up 'T�pp0 %� t R�te Valuation
PRIMAY PORCH 320 0-2 VAN 9l�iU�! $11.140 ffit ��594
Coil%tr•vction Fee b.asod on To-vai Artool Voluat9,an of $11891 is$ *92.50
SMI FIEE $01.011
M:CCROFIL" FEE
ANY P/C: FEC
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSrECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
'� '
—33
Ventilation System
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
z�.`
35
Furnace Comport.
3
Steel
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
loA
Fireplace T.O.
Ej
°o
- - - -
ADDITIONAL INFORMATION
"
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick •`RIS
Value
7A Walls (Batts)
12B Ceiling (Botts) —_
12C Ceiling (Blown)
14 Final `v
PLUMBING' APPROVALS - - - - - - - - - - - - - - -
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit 1. line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
a
t -
fi
!V
P/L P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding .
30 Fixtures '
31 Service
32 Final
STREET NAME