HomeMy WebLinkAboutBP 1977-1266 Chimney (for Ben Franklin Stove) FEE SCHEDULE Permit No. 1�l0A0 •
CITY BLDG. j ` CITY OF OAK MARK HEIGHTS Plan No.
STATE SURCHARGE ' 525' _ "T, (For Dept, use only)
BLDG. PERMIT -
CITY UTILITY
EXTERNAL, PLBG. APPLICATION FOR PERMIT
METRO S.A.C.
UTILITY CONNECTION Date S —� , 19T
T�
TOTAL AMOUNT DUE Ai L
STRUCTURE USED AS
REFRG HANG
MARK
BUILD PLUMB. HEAT INSTALL ALTER REPAIR REROOF RESIDE MOVE WRECK SIGN
SOUARES Y ' - /ma - 1 f ^I II
BY X °^
Owner E'�- ��' / r4+1 22 t CI> Address P�j /t/, t 7 �!h .3 T
Architect / C� Address
General Contractor _ Address
Contractor Reg. No.
NUMBER STREET SIDE BETWEEN WHAT CROSS STREETS
/k »1 7 /if .5 rN .514-0.1 t // _,t c.n . ct, uc l �
LOT BLOCK ADDITION OR TRACT
WIDTH DEPTH SIDE LOT CLEARANCE FRONT BUILDING LINE
• LOT
WIDTH LENGTH HEIGHT NQ OF STORIES TYPE OF CONSTRUCTION ESTIMATED VALUE
STRUCTURE � ^r
BASEMENT
❑ YES DETAILS OR REMARKS:
❑ NO frt. C -f Ana t % c.9 WG i -1., - 2 ,
� he un rsl ne t b f g ea e iby PP P iV /1 p 9 9 s lica atIp� erm o do Buildin g Work as herein sspecified, agreeing to do all work in Ict ordan with
all ordinances of the City of ddak Park Heigh(s. a Contractors must register with the village befo permit can be Is --
OWNER /CONTRACTOR SIGNED 0
OK'D BY