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BUILDING DEPARTMENT — <br />APPLICATION FOR BUILDING PERMIT AND CERTIFICATE <br />Applicant to fill in between heavy lines. . • OF OCCUPANCY <br />BUIkDIN A DRESS <br />`V-1 n <br />CLASS OF WORK <br />NEW I V DEMOLISH I <br />LO LITY 1 <br />7- <br />ALTERATION <br />ADDITION <br />MOVEIR <br />I <br />NEAREST CROSS ST. <br />USE OF BUILDING <br />ARCFTITECT <br />ENGINEER PERMITTEE <br />NA Ng: l,SL kit ,^ S� ^ G^, ,L_ <br />(cf j, L f <br />SIZE OF BUILDING <br />J (pX � HEIGHT i 7f - <br />1�/ } iJ <br />NO. OF ROOMS <br />1 <br />MAIL ADDRESS <br />P,o.go) - I•2- <br />NO. OF FLOORS <br />- <br />CITY TEL. NO. <br />O M< <br />NO. OF BUILDINGS NOW ON LOT <br />NAME - - <br />- <br />NO.'OF FAMILIES <br />SIZE OF LOT Z d -7� _d_/' <br />Tl�� <br />ADDRESS <br />USE OF BLDG. NOW ON LOT .-- - -. <br />CITY <br />SPECIFICATIONS <br />- FOUNDATION <br />STATE LICENSE NO. <br />MATERIAL <br />EXTERIOR 1 PIERS <br />CONTRACTOR • <br />NAME <br />WIDTH OF TOP <br />WIDTH OF BOTTOM -. <br />I <br />ADDRESS - <br />DEPTH IN GROUND <br />I " <br />CITY <br />R.W. PLATE (SILL) ' <br />STATE LICENSE NO. `.. <br />SIZE 1 <br />SPA. <br />SPAN <br />GIRDERS <br />• <br />LEGAL. <br />DESCRIPTION <br />SUBDIVISION - <br />I�S1'✓I 1 e `P1 /��I� <br />�L- `-- JB�LK�. <br />JOIST !sr FL. <br />'JOIST 2ND FL. <br />LOT NO. <br />p' <br />• P-18 / <br />r'� <br />JOIST CEILING ' <br />. <br />EXTERIOR STUDS <br />, <br />.1. District 1(rj.D q - <br />2. Type of Construction <br />I, II, III, IV, VI <br />3. Occupancy Group A, B, C, D, E, <br />F, G, H, I, _)Div. 1, 2, 3, 4, <br />- <br />4. Use Zone; <br />5. Fire Zone 1 2' 4 <br />INTERIOR STUDS <br />ROOF RAFTERS <br />BEARING WALLS <br />COVERING <br />EXTERIOR WALLS <br />ROOF <br />INTERIOR WALLS <br />REROOFING <br />• FLUES <br />FIREPLACE FL. FURNACE <br />KITCHEN WATER HEATER <br />FURNACE GAS OIL <br />i hereby acknowledge that I have read <br />this - application and state that . the <br />above is correct and agree to comply <br />with all City Ordinances and State <br />Laws regulating b 'lding co truction. <br />Applicant... . <br />BUILDING PERMIT NO. <br />X7`0 <br />VALUATION <br />5 000E9 <br />DATE ISSUED <br />AcG,agr 7 <br />BLDG. FEE <br />$. 5co <br />PLAN CHK. FEE <br />TOTAL <br />BUILDING <br />PLUMBING <br />FOUNDATION • • <br />ROUGH <br />ELECTRIC <br />ROUGH <br />FRAME <br />PLASTER <br />SEPTIC TANK <br />FINISH <br />SEWER <br />FIXTURES <br />FLUES <br />GAS <br />_ MOTORS <br />FINAL <br />• FINISH <br />FINAL <br />?�C -14C.6 r uVP`f Vim' 4 <br />Approved: CHIEF BUILD G OFFICIAL <br />By: <br />3N11 A11:13dO8■ <br />A <br />PLOT PLAN <br />3NI7 A143dO21d <br />STREET <br />MAP NUMBER <br />-No. ASSIGNED BY <br />FIELD CHECK BY - - <br />DATE <br />PLANNING & ZONING INFO <br />TYPE OF OCCUPANCY <br />TOTAL FLOOR AREA <br />NUMBER OF STORIES • TOTAL. HT. <br />AREA OF LOT <br />FRONT YARD SETBACK FROM PROP. LINE <br />SIDE YARD SETBACK FROM PROP. LINE <br />REAR YARD <br />NEW CONSTRUCTION ALTER <br />CHANGE OF OCCUPANCY FROM <br />To <br />