HomeMy WebLinkAboutBP 1975-884 Remodel Bath Facilities ( 3 S -f . C ,-9-
FEE SCHEDULE Permit No. O �(
VILLAGE BLDG. (n•Or) VILLAGE OF OAK PARK HEIGHTS Plan No.
i OQ (For Dept. use only)
STATE SURCHARGE
BLDG. PERMIT 7•00
VILLAGE UTILITY
EXTERNAL PLBG. APPLICATION FOR PERMIT
METRO S.A.C. r
UTILITY CONNECTION Date. lt\ 19 IC
TOTAL AMOUNT DUE
STRUCTURE USED AS
REFRG HANG
MARK BUILD PLUMB. HEAT INSTALL ALTE REPAIR REROOF RESIDE MOVE WRECK SIGN
SQUARES
BY X
Owner s Cg� ��ct.� Address
Architect Address
Genexsd Contractor (y9 .Lu ,d_( 1.U..tt j Address 1 \e—
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
LOT P] CX K ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
LOT
WIDTH LENGTH HEIGHT _NO.OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE
BASEMENT YES
DETAILS OR REMARKS:
❑ NO
The undersigned hereby makes application for a permit to do Building Work as herein specs • d, agreeing to do all work in strict accordance with
all ordinances of the Village of Oak Pork Heights. Contractors must register with the villa efore rmi c be iss d.
`'WNER,'CONTRACTOR SIGNED t'S !/ —op`�—vti•i
OK'D BY