HomeMy WebLinkAbout104 Gordon Drive (4) eectric# 1-17C61fca APPLICATION FOR BUILDING PERMIT
Plumbing# 104 Gordon Drive
HVAC # No 28895
Date:
Sprinkler#
FINAL APPROVALS Estimated Cost $3 006,
Building -j `d Z— COMPLETE RED BOXED AREAS Permit Fee
Engineering � TYPE OR PRINT ONLY Occupancy Fee �
Affidavit _ ,� SIGN ON REVERSE SIDE G
Appr.for CO. Total Fee $ Vr•
TO BUILDING ARTMENT,TOWN OF SOUTH WWSOR,CT Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location I j a C(,;A a„ Y)e, Lot No. Side of Street Zone
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Applicant ��r 1� ��, �-�.'►ncl��S C� �i Tel.# �,,ci -S 30'`7 :3-�
Addr ss_ W Vy c hc, "I 011 Zip CLo rl L( Lic.# S-+'W 1 ) '1
Owner_L�-t cc v,-%bA-- Address i r,,-i V c A W f.)
Architect Address
Sq.Ft.New Area: 1st Fl. 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories #Bathrooms #Garages
Purpose of this permit: LQ On YX..(l6
City Water ❑ Well ❑ Septic System ❑ Sewer ❑
Ins. H.O. S.P. Cert. V Area Basement Garage
Approved by Date a I.,Use Group Construction Typ
Revised 9/01
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this
permit is asked,and agree that this building is to be located the proper distance from all street lines,side yard lines,and required
distances from all other zones and is located in which this building and its use is allowed.
Signed -�� l� o�.
I hereby apply for a Certificate of Occupancy for the work described i is application for the permit.
11
Signed �/ ? '
DO NOT WRITE BELOW THIS L E
INSPECTION COMMENTS