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<br />CITY OF L01JISVrLLE- BUILDI;\G SAFETY DIVISION
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<br />RESIDENTIAL PERMIT APPLICATION
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<br />ADDRESS OF ,JOB: !;01 0/1(0 t-t ~ PERMIT l\'mmER:
<br />LEG.\L DE,CRITIO" WT: 1,1-,. BLOCI-::::; SUJDII'ISIOr-;: 4CILtA i2({{U-
<br />CLASS OF II'ORI-:: "Ell () ,.II)DIT[O\;: I I "ll.TERATIO:--i: () REI',IIR: () 1100'E: I ) DD10LlTI0,\;: (,j
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<br />OII']\;ER (Cl,t ,mlICR L. L.tUvlUllp ADDRESS: '11'" M 6vtrce Ikl::4( CITY:S~'V{, &,ZII': S'(J1!Z7-
<br />C(,,,TRACTOR LOUISVILLE L1CEi\SE # 9 CITY: I'HO"E:
<br />N,\ME: ADDRESS: ZIP:
<br />JOB SLI'ERVISOR: MOIJILEII'AGI:R" JOHSITE I'HO"E 'r:
<br />i:RCIIIT~CT Er-;GI:\EER OF RECORD: > _ . COLO, L1CE:'<SE " I'HO"E:
<br />I\II,IIE: f1>tt ,dill , ADDRESS: CITY: 1.-'1, . ZIP: CC,
<br />DESCRIPTI N OF WORK: FILL IN ALL APPLICABLE BOXES PLEASE INCLUDE SO. FOOTAGE
<br />I" FI.OOR AREA: 1'3310 cod FLOOR .-\REA: - G..\RAGE ARE.I: 4~"() OTHER:
<br />IlASE'\IEI'T AREA:
<br />TO IJE FII'ISHED: 'fI5if L'NFI"ISHED:..-- SPRI"KLED "REA: -- ,,\IC ARE.\:
<br />TOTAL LOT AREA (SO.FT): ROOF COVERING: EXTERIOR WALL COVERING:
<br />('OSS7Ru('no,\' TTPE: 0('('('/',,1,\'('1': VttCa-.,j- rl'l'E or FO[l,\'[).l no\s: 107:IL U.\'IIS:
<br />ELECfHlCAL l'EH.:\lIT I:\FOn\lATlO:\: I'ER\IIT TO I.\CLl;IlE ELECTHICAL WORK ( ) ,,\'01' API'L1CABLE ( )
<br />CUr-;STR\ 'CTIO~ SERVICE l::j'\'/l{ANCE 5JGJ\'$ EI.ECTRll.'AL ,\Pl'LlANCE fIRE lJETFCTJ(I)'\ SYSTE:>.1
<br />:-.IETER SIZE SIZE TYI'E TYPE IYI'E
<br />I'LlIi\1BI:\G J'EK'lIT Ii'\FOIOIATJO.'\: P[R'lIT TO I.\CLrln: 1'L\!.\IBl.'\G Wunh: ( J ,\OT Al'l'l.ICAllLE ( )
<br />U:\C~J-LO\\' Dl:\'ICE \\'A TER HEATER FIRE SPRIJ\'f\.LER SYSTEM V,'/\ TER REI'AII,
<br />1\lAKE1MODEL BTU J\!I'UT ,\REA
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<br />RECEIVED
<br />(303) 33:,...j:,S-4
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<br />CITY OF LOUISVILLE
<br />CITY MAN,:,GER
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