Laserfiche WebLink
<br />~. ..';'~'''':', '7"":', '~fED <br /> <br />.~. ..::; "::-:", ,"?'. -..: ~~. <br />,,:;.:;,',! .~~:...."! ::Oi.~.!. ;t;J\>'ltt1 Ji,~ "" -- <br /> <br />CITY OF LA PORTE <br />.'. PERMIT APPLICATION FORM <br /> <br />INSPEc"rION~ <br />/L2..':~;?,6 ~f73 <br /> <br />'- <br /> <br />BUILDING <br /> <br />L <br /> <br />MECHANICAL <br /> <br />*ELECTRICAL *PLUMBING <br />*(SEE BACK OF FORM) <br /> <br />=====================================================~~==================== <br /> <br />')VPROJECT ADDRESS: q&O) J5-e/ hc;t fLOT if,: <br />>'sUBDIVISION ~ 1(1 k t::C0-: .:5eJ-:? )&sLOCK ~ <br />r.,WNER 's NAME. _ _~ (/'/1 ~HONE I <br />~ADDRESS: F.xJ F&s+:M3 1.D''r'' !'Ii.~~ ~ ~ <br />/ STREET crT <br /> <br />CONTRACTOR: <br /> <br />iJ vh ~ <br />2 tJ J <br /> <br />5 f 4-4-?) e.-1I <br />V.l--t1- I/p <br /> <br />, <br /> <br />;) 7/ <br />/(fl <br />-47)- J.. ct.1h <br />~/S-j1 <br />ZIP :;l: <br /><.41 <br />~.' <br /> <br />PH: <br /> <br />ADDRESS: <br /> <br />1 \ <)t <br /> <br />L~tt,--h <br />CITY <br /> <br />,,757/ <br />ZIP <br /> <br />STREET <br /> <br />ENGINEER: <br /> <br />" <br /> <br />DESIGNER: <br /> <br />)oUILDING USE: HohL-L <br />.f,n Df;'DOO <br />VALUATION: ~ <br /> <br />SQ, FOOTAGE: <br />~SCRIEE WORK: <br /> <br />( I ;;2., () <br /> <br />>?'sTORIES: <br />, <br /> <br />//{; I /') c' e <br /> <br />/1/I(f)j ""'/ I~ Hf...~ <br /> <br />r:1.-o ;,.::J ~ 5 rq 'f"'i /~ j <br /> <br />--------------------------------------------------------------------------- <br />--------------------------------------------------------------------------- <br /> <br />--FOR CITY USE ONLY-- <br /> <br />OCCUP T.YPE <br /> <br />FLOOD ZONE <br /> <br />CLASS WORK <br /> <br />.SQ. FT. <br /> <br />r' <br />.~..:..", <br />~KG' REQ .. <br /> <br />CONsLTYPE <br /> <br />USE ZONE <br /> <br />~ STORIES <br /> <br />COMM. BLDG. PLANS ONLY - FIRE MARSHAL APPROVAL: <br /> <br />...D.~tE : .~ . <br />.... . .J" <br />-:;.-=-' . <br /> <br />CHECKED/APPROVED FOR ISSUANCE BY: <br /> <br />q~TE: <br />. 1'J...<. h...<P.....{.I~ Ci!.\N.,f,:,.., At .,., ..t../"I:J /Ilv......),<./' <br /> <br />SPECIAL CONDITIONS: <br /> <br /> <br />1'XFL'fAF).,5 I;z.o9937) /) 1'\1:)1: "'L- Mddv/~r h.o"""~. r+ 1$ CL Huo.<:..oJ-t.. ",.,~...A~fv'r"-,I 4'"OYI.A... <br /> <br />===============================================;~~~~:=1~/i:1.(g2= <br /> <br />PERMIT NO. <br /> <br />PERMIT FEE S <br /> <br />(ATTACH TO ACTUAL PERMIT) <br /> <br />=========================================================================== <br /> <br />~ <br /> <br />REV. 3-92 <br /> <br />EXHIBIT A <br /> <br />A:PERMITAP.ORG/DEPT. FORMS <br />