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BUILDING
PERMIT No.
N? 212
OWNER
MAIN
WIDTH
DEPTH
ADDR�
r
PHONE
DATE ry .1 /y
BUILDING
�(
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7
VL'
BUILDER
FT. "
ADDRESS
r
SIZE
ARCHITECT
WIDTH
DEPTH
AREA
ADDRESS
JOB
ADDRESS
STRE T
bf° _. IV.*
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UyBEj1.d ,y, ,�
/Pf� A4
«
/ a
G G I
G•
_
USE ZONE
LEGAL
,�
J
LOT SIZE K
o 1_
0 ? /
/ . : --
'
LOT � i.
BLOCK
y✓ I G"r GN 1
YARDS -
MAIN
SET BACK
SIDE YARD
REAR YARD
NEAREST
ACCESSORY
SET BACK
SIDE YARD
REAR YARD
NEAREST
DISTANCETO
BUILDING
1
BUILDING
BUILOINO
BUILDING
PROPERTY LINES
/�
EXTERIOR
FINISH
CLASS OF WORK 11/,.5 U_S`',le:' /'; k A" R Ao U ,-_ iqT t_.? /" 714 6 11V Apb i- a IT - De9 ve
REMARKS DESCRIPTION OF ANY WORK NOT COVERED ABOVE
e Air 0- e M PL P71
WARNING Notify Building Department by Street Address and Permit Number when ready for inspection. Work must not be
co vered 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 I further agree
to comply with all City Ordinances, State Laws, and lawful orders of the Building Inspector governing building con-
struction. )
Written Authorization of the owner must be pre-
sented when work is done by occupant or lessor. OWNS } � DY X
PERMIT FEES: (THIS SPACESQR BUILDING DEPARTMENT USE ONLY)
HOUSE EI OTHER MISC.
HOUSES G ARAGE S G ARAGES 16 BUILDI S FEES S
O e7
REt~EI /`
BOND NO.- TOTAL FEES i tR BY BY DATE y e a
NOTICE THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THE WORK
MAIN
WIDTH
DEPTH
AREA
TYPE OF CONSTRUCTION
BUILDING
�(
_
FT. "
FT. � 8q, F7.
SIZE
ACCESSORY
WIDTH
DEPTH
AREA
OF
BUILDING
BUILDING
X
_
�
�� y
FT. � `
FT. 80. FT.
, FT.
EXISTING BUILDING AREA---------- - --
SQ. FT.
TOTAL AREA OCCUPIED
LOT AREA
LOT AREA OCCUPIED
LOT COVERAGE
py
SQ. FT, •
SQ. FT.
/�
EXTERIOR
FINISH
OCCUPANCY
TO Be USED
HOW
BASEMENT
AS
w �
` / GAF.
HEATED
SIZE SQ. FT.
ROOMS
TOTAL
DEO �7
`
ROOMS J
BATHE
, LIVING /
L•D
COMBO
DEN
KITCHEN
NOOK
K •D
NOOK
ATT. ❑
GARAGE
DET. (�
_
VALUATION OF
HOUSES
GARAGE $
HOUSE - ATT. GARAGE $
OTHERS
AL LIMPROVEMENTS
'5 doo
FOUNDATION OK
FRAMING OK
FINAL INSPECTION
REMARKS DESCRIPTION OF ANY WORK NOT COVERED ABOVE
e Air 0- e M PL P71
WARNING Notify Building Department by Street Address and Permit Number when ready for inspection. Work must not be
co vered 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 I further agree
to comply with all City Ordinances, State Laws, and lawful orders of the Building Inspector governing building con-
struction. )
Written Authorization of the owner must be pre-
sented when work is done by occupant or lessor. OWNS } � DY X
PERMIT FEES: (THIS SPACESQR BUILDING DEPARTMENT USE ONLY)
HOUSE EI OTHER MISC.
HOUSES G ARAGE S G ARAGES 16 BUILDI S FEES S
O e7
REt~EI /`
BOND NO.- TOTAL FEES i tR BY BY DATE y e a
NOTICE THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PERMIT PLACARD MUST BE POSTED ON THE WORK