Pecan Hollow/PP-CS 920731BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Date:
.28' mock: Pr
Subdivision: ~/k[ ~fO(--l~O CO
Phase or Section Number:
Address: / q 7 /~,..0{~ ~rl~--~' ~ Phone #:
Contractor: ~X~i~A g3, l~ ~)(.~_~
,Description of Work to be Done Class of Work:
Address:
]New
I g'll..tla.''i - ~ .
[']Addition [] Alteration
[] Repair [] Demolition
Area of Building in Square Feet
First Floor
Second Floor
Garage
Other
Value of Work
to be Performed
(1 oo0
NOTICE
This permit becomes null and void if work or construction authorized is not commenced
within 180 days, or construction on work is suspended or abandoned for a period of 180
days at any time after work is commenced.
I hereby certify that I have read and examined this application and know the same to be true
and correct. All provisions of laws and ordinances governing this type of work will be
~omplied with whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other federal, state or local law
regulating c~.4, i°n;r~ance °f c°nstnacti°n'
Si~ature of Contractor or Authorized Agent Print Name
Electrical Contractor Plumbing Contractor Mechanical Contractor
81R- 1 (2/92)
GRAY AREA FOR OFFICE USE ONLY
POrm,t Fee:..~..::~.: ~ ~:.~ i:': :./: '.'i ii ;i :/:.:::::. :. :'::ReCeiPt N0r~'ber!/: