HomeMy WebLinkAbout171 Bourbon Street (15)ectric# APPLICATION FOR BUILDING PERMIT
Plumbing# 171 BOURBON STREET
HVAC # 25402
Date:7-- l
Sprinkler# No.
ODFINALREstimatedCost70 •
Buildi t COMPLETE RED BOXED AREAS Permit Fee 41 -
Engi TYPE OR PRINT ONLY Occupancy Fee $
Affidavit SIGN ON REVERSE SIDE
Appr.for CO.Total Fee
TO BUILDING DEPARTMENT,TOWN OF SOUTH WWSOR,CT Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location IZI daje--4464-AWE-C-r Lot No. Side of Street Zone
Applicanrw U Tel# 4.f3 -- I d
Address D Zip t7c I t. Lic.# vc
Owner Address lSyj
Architect Address
Sq.Ft.New Area: 1st A 2nd FI. 3rd Fl. Total New Area
Rooms avatones Bathrooms Garages
Purpose of this permit:
r•
City Water 0 Well Septic System 0 Sewer
Ins. H.O. S.P. Cert. Area 0 Basement Garage
Approved by Dat j 11trf Use Group Construction Type
c
R.v6ad 1197
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 locat the per dis a from all street lines,side yard lines,and required
distances from all other zones and is located in whic buil ' g and its is all
Signed
I hereby apply for a Certificate of Occupancy for the work described in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS