HomeMy WebLinkAboutPermit 53 - Roth Residence - Fireplace charles Roth Residence
BUILDING
PERMIT No,
N2 53 i
OWNE
~
ADDRESS
PHONE
IJATE
BUILDER
ADDRESS
FT. " FT. � 80. FT.
ARCHITECT
ADDRESS
ACCESSORY W
WIDTH DEPTH AREA
.JOB
ADDRESS
STREET
BUILDING B
NUMBER
X —
USE ZONE
LEGAL
FT, FT. — 80. FT,
LOT SIZE
LOT AREA
EXISTING BUILDING AREA----------- - --
LOT
BLOCK
YARDS
DISTANCE
PROPERTY LINES
MAIN
BUILDING
SET BACK
BIDE YARD
REAR YARD
NEAREST
BUILDING
ACCESSORY
BUILDING
SET BACK
SIDE YARD
REAR YARD
NEAREST
BUILDING
rl AGG nF' WnRK All 0- - iJ '0 4-&�n At1&:�_' / .i/ Z /�',o=
ALL IMPROVEMENTS HOUSES B GARAGES ATT,GAR AGES OTHERS
FOUNDATION OK FRAMING OK =FINAL INSPECTION .
REMARKS: DESCRIPTION OF ANY WORK NOT COVERED ABOVE
I
WARNING Notify Building Department by Street Address and Permit Number when ready for inspection. work must not be
covered before inspection and OK for covering has been given by Inspector in writing on Permit Placard.
I hereby acknowledge that I have read this application and state that the above is correct and 1 turther agree to comply witn all
Town Ordinances, State Laws, and lawful orders of the Building Inspector governing building construction.
Written Authorization of the owner must be pre-
sented when work is done by occupant or lessor. OWNE ,42eLF'S 207 BY
PERMIT FEES: (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY)
HOUSE@ OTHER MI SC.
HOUSES G ARAGES G ARAGE S BUILDINGS S FEES S
2 nECEIVE PERMIT )`
BOND NO. TOTAL FEES $ B Y BY ATE I 4��6
NOTICE: THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THE WORK
MAIN W
WIDTH DEPTH AREA
B
BUILDING T
X —
FT. " FT. � 80. FT.
SIZE
ACCESSORY W
WIDTH DEPTH AREA
OF A
BUILDING B
BUILDING X
X —
FT, FT. — 80. FT,
Bq. FT,
EXISTING BUILDING AREA----------- - --
SQ. FT,
TOTAL AREA OCCUPIED LOT AREA LOT AREA OCCUPIED p
LOT COVERAGE —
py
/�
8q. FT. 80, FT.
EXTERIOR
FINISH
OCCUPANCY T
TO BE USED H
HOW B
BASEMENT
AS H
HEATED S
SIZE SQ. FT.
ROOMS I T
TOTAL B
BED A
ATHS L
LIVING L
L.D D
DEN ±
EN N
NOOK K
K•D G
GARAGE ATT, ❑
±HO E
/ V-4
VALUATION OF /
REMARKS: DESCRIPTION OF ANY WORK NOT COVERED ABOVE
I
WARNING Notify Building Department by Street Address and Permit Number when ready for inspection. work must not be
covered before inspection and OK for covering has been given by Inspector in writing on Permit Placard.
I hereby acknowledge that I have read this application and state that the above is correct and 1 turther agree to comply witn all
Town Ordinances, State Laws, and lawful orders of the Building Inspector governing building construction.
Written Authorization of the owner must be pre-
sented when work is done by occupant or lessor. OWNE ,42eLF'S 207 BY
PERMIT FEES: (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY)
HOUSE@ OTHER MI SC.
HOUSES G ARAGES G ARAGE S BUILDINGS S FEES S
2 nECEIVE PERMIT )`
BOND NO. TOTAL FEES $ B Y BY ATE I 4��6
NOTICE: THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THE WORK