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HomeMy WebLinkAbout106 N DUNHAM_00728_2026 -7 City of Ar" - ngton Permit No. NOTICE and Inspetaxon Report Date Called Address I Z6 AAA /v? 91 Time Called Contractor/Owner By Requested by TYPE OF • REQUESTED ❑ Setback ❑ Reroof ❑ Insulation Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other APPROVAL ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. XWork listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION-24 hour notice required. Inspector Date _ � T I"y mA Em h'-M ,2 7ff,7 l! 1 r - - I Oil u- i 1 z ■ 1 1l )i •1 IJ 1 I,11 '1 1 rj _ 1 Ml III Permit No. / ;' ' City of Arlington NOTICE /and ,�Inspe...ion Report !0,h /V Date Called Address 2kVAe }i_._ Time Called Contractor/Owner 115�,'4Ayo5— By Requested by & TYPE OF • REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing anal ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other_ ❑ APPROVAL ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved- ❑ Work listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION-24 hour notice required. Inspector _ �3 �: t 1lII' -ir►w 0 q REF n ej *gtwjl h"D 2yt'nV! !LY111►I wm T- Wp 111 • Iri1= : I sit 16104 • l_N•,',tl ^IIIATLT/ o �YIva� II J�Ar- 1 _ ;;I�r� :vI 1pa1-1•Ily tul Ju:M: a.:�, .��t a�i�wloJ: . 1 ri"1- IDS•: ��C �_:�"i -J I'`1,1: I1�'1,1 per r� fir, :sIQ 1 { - - INN Permit No. City of Ar 'igton � - NOTICE and Inspecs&on Report Date Called Address-�0/0 L _fr Time Called c Contractor Owner By Requested by � TYPE OF • REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other Ix APPROVAL ❑ CORRECTION REQUIRED ❑ rrections listed below MUST BE MADE before work can be approved. `k listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION-24 hour notice required. Inspector Date �'` uj All 1r - --��T 11J II -�` =- rr I LL l_ _ 1 1� l• II - • Permit No. City of Arlington NOTICE and Inspeudon Report Date Called Address Time Called Contractor/Owner By Requested by TYPE OF • ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other .w--t ❑ APPROVAL ❑ CORRECTION REQUIRED Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION-24 hour notice required. m 79/ � S Inspector Date ;, `� � . 4 .. . \ � � ,.,` i �_ -� - �� r- , � „�, - �Wit,, . . . . . �.�� � y � : r�� �� a . . � � � ,� �r, � Permit No. i ^�i(� City D1 Arlington NOTICE and Inspection Report Date Called Address Time Called Contractor/Owner �/(�� By Requested by­ TYPE OF • ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ I.,Drywall Nailing 1 VrFival ❑ Concrete Slab ❑ Rough-In Plumbing E] Reinnsspection ❑ Shear Wall ❑ Furnace ❑ Other ❑ APPROVAL ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION-24 hour notice required. �1'A'Ze p� 7 o J Inspector Date '�v _ -�f l ,�� ` � � � _• ,. . ,�,�- .�� j �t • � �y � ?� ,� �. ., •� �: -�Permit No. City of Arlington NOTICE and Inspection Report Date Called Address Time C Iled CIZO Contractor/Owner By Requested by TYPE OF • ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace (_] Other- ❑ APPROVAL CORRECTION REQUIRED n fork can be approved. d. dice required. � or t{ 1 I r S;A Inspector Date _• _ • - -C—r. fads-",I I ?0 _.illol - �l.Ql�%iM�L.;may-N-ql � I wc I -� I 1■ I 1 -F%- 7 I I 1 .1 f1 ZLR— in At- J~- ► I■_ J T-I Ill _ I I LEI ui. — 1 1 .19 ■ r, — 1 — Lill l _ 1 ■ I F_` -?�.q\ _ l r1 I _ M 6''•1 lti�1- l`J� j Ki F► J-.1 - — - _—-r. r _ _ I Permit No. City01 Arlington NOTICE and Inspection Report Date Called Address 1 b 6 tom( Time Called �21�'� Contractor/Owner By JA Requested by TYPE OF • REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing Reinspection ❑ Shear Wall ❑ Furnace ❑ Other �114PROVAL ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑l CALL 435-0724 FOR REINSPECTION-24 hour notice required. Inspector ,�(�yy �iL Date 61 oj\� % City of Arla ngton rmit No. �b �,,s,�. 1,� NOTICE and Inspection Report Date Called Address J Time C II d Contractor/Owner b Byt Requested TYPE OF • ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other APPROVAL ❑ CORRECTION REQUIRED (� Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION-24 hour notice required. Inspector Date I*"— -.IN.L'r .+ L a?'— . ff+� r�:•i►ii1 tw r. �h�yii.K!�: N Mi • ' }ii. rxyj - - - - - - - L3 ri — 1 ■ WIN 1 _ ■ — jll —� _ ■ ■II n — 1 n •m 1 " ;ra - n nl.n �II!� .• n !� n 1 J ■11. 1' . 1 '— 1 I IT Permit No. -City of Arlington � NOTICE and Inspection Report Date Called �j,7 Address Time Called — Contractor/Owner l By 44 Requested by TYPE OF • REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab j.=J Rough-In Plumbing einspection ❑ Shear Wall ❑ (�/Cther_ Furnace APPROVAL ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. 5<rk.listed below has been inspected and approved. ❑ CALL 435-0124 FOR REINSPECTION-24 hour notice required. Inspector Date • r 11 '• Ir I I I -4,A-Mi ' .1 - `-- &*-, n � TI ILL I��' 1 - n _ _d _ -t - _1 1 /\I F7� Irlll r An 1 TP CA I•,_ , I_ h� �• .. ti / 41 Mil A -d r s 1 lot r. J 00 r CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT, NO.00728 OWNER MAIL ADDRESS CITY ZIP PHONE Housing Hope, P. 0. Box 7823 , Everett, WA 98201 258-2214 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE Stephen Story, P. 0. Box 2443, Mt. Vernon, WA 98273 , 336-3371 GENERAL CONTRACTOR MAIL ADDRESS ( ZIP PHONE LICIENSE ?�.A►� _�c 17 a t S �o t�aL, a ruTT � <<"�,��yt � �ZZ3 ��9 �ssl MECHANICAL CONTRACTOR MAIL ADDRESS I CITY T-- ZIP PHONE LICENSE� ,mil rXC ;9/�/Z PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE(Y CLASS OF WORK ❑NEW ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK f131 000. 00 DESCRIBE WORK Add to existin sin le story residence to creatlm PRUPOSE D USE OF BUILDING HOU iri f I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- LLGAL DES(RIP ION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LUF91 10 BLOCK 5 OF V 2 O' WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE of Arlingtor GRANTING OF PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF 3788 0050090002 CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. IOBAUURLSC SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE 106 North Dunham Arlington X (OFFICE USE ONLY) PLUMBING MECHANICAL NO. TYPE OF FIXTURE FEE j NO, TYPE OF EQUIPMENT FEE 3 WATER CLOSET (TOILET) 6 00 1 AIR COND. UNITS -H.P. EA BATHTUB 6 00 1 REFRIGERATION UNITS -H.P. EA. 3 LAVATORY (WASH BASIN) 6 00 BOILERS-H.P. EA SHOWER GAS FIRED A.C. UNITS-TONNAGE EA KI ICHEN SINK & DISP. 6 no FORCED AIR SYSTEMS- B,T.0 MEA 3 DISHWASHER Is, no WALL HEATERS- B.T U M LAUNDRY TRAY UNIT HEATERS- B.T.0 M CLOTHES WASHER EVAPORATIVE COOLERS WA ER HEATER 6 00 CLOTHES DRYERS URINAL VENTILATION FAN DRINKING FOUNTAIN RANGE HOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT- CPM 3 VACUUM BREAKERS 6 STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR,ETC.) WATER HEATER GAS PIPING SUBTOTAL f 42 On SUB TOTAL $ PERMIT ; PERMIT ; TOTAL FEE ; TOTAL FEE ; SIDL YARD SL[BACK STREET SETBACK REAR YARD SETBACK PPLANECK NUMBER PLAN CHECK FEE 65/15 32 40+ 10-91 F�86, 20 RECEIPT NO USE/.ONE LOT AREA VACANT SITE 24613 MR2 9075 ❑YES NO FEES VALUATION FEE TYPE OF CONST OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG VN R-1 3 BUILDING f - SIZE OF BLDG. NO.OF STORIES MAX.00C.LOAD � � �- 2845 2 14 PLUMBING If 57 100 FIRE SPRINKLERS REQUIRED ❑YES E]NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE 8 50 PENALTY U B.C. SEC.303(a) Mechanical requires separate permit WATER/SEWER FEES PA11 " TOTAL - PERMIT VALIDATION �� WHEN PRO�Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT&RECEI Z i ` PAID !199 CR BY L cc:ASSESSOR,APPLICANT,TREASURER, BLDG.DEPT. 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Ill a 00 .3 CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. /�e OWNER MAIL ADDRESS CITY ZIP PHONE kou S�ra IAV Fe- P.0. but, ltzs vel-6 quol a5b ZIk 14 ARCHITECT OR DESTGNER MAIL ADDRESS CITY ZIP PHONE �e.nh�n ` 6nl PA. `bol 2447) Ufmwn 3 `6% GENE RAL CONTRACTOR i MAIL ADDRESS CITY ZIP PHONE LICENSE N MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK ❑NLW JOADDITION ❑ALTERATION ❑REPAIR ❑DEMOLI TION ❑BUILDING RELOCATION VALUATION OF WORK s 131 wo DESCRIBE WORK AaA b exish i S resi akc_ 5 PROPOSED USE OF BUILDING � rk /���� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- �'5 is TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LEGAL DES(' IPHON Of PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOI 1` 0 BLOCK 5 OF V01, 2 age 9 Pal 0,;i1 o WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE �8 dOSO® � �Q(� Ay -) GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE I URI.SS >4 1A x (OFFICE USE ONLY) MECHANICAL PLUMBING NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSEI (TOILET) AIR COND. UNITS - 11.P EA. BA I11 T UB REFRIGERATION UNITS-H.P. EA. LAVATORY (WASH BASIN) BOILERS - H P EA SHOWER GAS FIRED A C. UNITS- TONNAGE EA. �j KI ICIILN SINK & DISP. FORCED AIR SYSTEMS- B.T.U. MEA 3 DISHWASIILR WALL HEATERS- B T.0 M LAUNDRY 1 RAY UNIT HEATERS- B.T.U. M CLOTIIES WASIIER EVAPORATIVE COOLERS W'AIER HEATLR CLOTHES DRYERS URINAL VENTILATION FAN DRINKING FOUNIAIN RANGE HOOD COMMERCIAL FLUOR DRAIN AIR HANDLING UNIT - CPM VACUUM BRLAKE S STOVE ROOF DRAINS - RA LEADERS METAL FIREPLACE&CHIMNEY SINK (SERVICE - BAR,ETC.) WATER HEATER GAS PIPING SUB T TAL f SUBTOTAL f PERMIT\ S PERMIT f TOTAL FE` $1 TOTAL FEE f SIDLL_YARD SE I BACK STREEI SETBACK tt REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE (D l k 57 32- f /9 �� FEEE I i? // RECEIPT NO. USE LON LOT AREA 1 VACANT SIt�o �IXY/ 4 O ❑YES / FEES VALUATION FEE T PE OF CON1;7. OCCUPANCY GROUP NO OF DWE LING UNITS PLAN CHECKING NG VA/ v BUILDING f SIZE OF BLDG. NO.OF STORIES MAX.OCC OAD �s(jL C�?_ PLUMBING FIRE SPRINKLERS REQUIRED ❑YES NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE S� �^ PENALTY U.B.C. �' � I .J� SEC.303(a) IML,z y AmhL A ` "]� �v� U WATER/SEWER FEES /�S TOTAL o PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS IS YOUR PERMIT&RECEIPT PAID CRq BY cc:ASSESSOR,APPLICANT,TREASURER. BLDG. DEPT. BUILDING OFFICIAL DATE RECORDS COPY ,..._ �_ _ _ �- - . . •, _- -- .0- ` � - � I ., � L ' _ - - - City o� ARLINGTON PERMIT AP—(CATION 230 N. OLYMPIC AVE., ARLINGTON, :8223 (206)435.5785 am ' COMMERCIAL, RESIDENTIAL, MECHANICAL, PLUMBING, GRADING a Tax Account Number Job Site Address City Applicant Name /Cl K f cy �� Phone .S Y ) Mailing Address-/�e9 Q �!J�'C . ,�!y � City ` CV W"4^ J (' Zip- Contractor Name License # Address City Zip-_ Phone Architect/Engineer License # Address City Zia Phone TYPE OF PROJECT �� F21 Sewage Disposal Right-of-Way Width Culvert Permit No. LOCATIONAL INFORMATION: SEC TWP RGE 16th Plat Name/Short Plat No./Segregation No. n��� �'�-/1��.vr�7� Lot/Parcel # Block # Lot Size Is the average slope of the property in excess of 25%? Yes No Has construction started? Yes No This structure will be used for the following purpose Other buildings on this property OWNER/AGENT SIGNATURE DATE NOTICE: Front Yard Setbacks. Curbs, Sidewalk Ed , Edge 0 Street pavement is not necessarily your front property line. In the case where your setback will be measured from the front property li e,be certain that you are measuring from the actual front property line and that your plot plan depicts this. In the event your setback will be measured from a private access easement, the edge of the improved road is not necessarily your front property line. Be certain that you are measuring from the edge of the actual easement and that your plot plan depicts this. ACKNOWLEDGED ---------OFFICE USE ONLY BELOW THIS LINE------------- PERMIT CONDITIONS . . . ----------- ZONING: Max Lot Cover o /o Max Bldg. Height ft SETBACKS: Front Side Rear Basic Plan #_ Other Covenants SPECIAL CONDITIONS . . . SANITATION — ON SITE _ LETTER PUBLIC WORKS ENV HEALTH DRAIN TRAFF — — SEWER CN R/R RD IMP OCD ACCESS RSBP ESMT RSME LS STD BLA D SLIDE CMBP — ADDRESS PLBG SLOPE CMME _ SP— CULVERT MBHM 5 ACRE _ SEPA SITE PLAN — AFF/BOND MOVE — OTHER FIRE GRADING LOTS — OTHER INSP 20 ACRE OCP CU FL ZN FML BLA — PLAT REZONE SEPA SH LN — SP VAR----- SU VA PLUMBING PERMIT MECHANICAL PERMIT (NOT . .jR MOBILE HOMES) [ 1 3 FIXTURES No. UNIT TYPE: LPG Solar Electric Oil_ Gas Water Closets KW Bath Tubs UNIT SIZE: BTU's Shower Baths FEE Wash Basins _ No. FOR THE INST. OR RELOC. OF Sinks Forced Air Systems Dish Washing Machine Fuel Storage Tanks Hot Water Tanks Heat Pumps Drains Wood Stove Laundry Washers Fireplace Insert — Laundry Trays —0— Clearance Fireplace Urinals Drinking Fountains Rain Leaders Sumps Vacuum Breakers Permit Fee Gas Piping Side Sewers Total Due $_— Water Service Line Misc Total Fixtures GRADING/FILL INFORMATION Permit Fee No. of cubic yards: Total Due $ To be removed from site Related Bldg. Permit # To be imported to site IF MORE THAN ONE BUILDING, SUBMIT SEPARATE APPLICATION FOR EACH STRUCTURE. A SEPARATE BUILDING PERMIT MUST BE ISSUED FOR EACH BUILDING. [01 BUILDING DIMENSIONS: MAIN FLOOR MAIN FLOOR SQ. FT. SECOND FLOOR SECOND FLOOR SQ. FT. THIRD FLOOR THIRD FLOOR SQ. FT. FOURTH FLOOR FOURTH FLOOR SQ. FT. MEZZANINE MEZZANINE SQ. FT. BASEMENT BASEMENT SQ. FT. GARAGE GARAGE SQ. FT. CARPORT CARPORT SQ. FT___ DECK: DECK SQ. FT. — NUMBER OF FIREPLACES TOTAL SQ. FT. R OFFICE USE ONLY ROUTING SCHEDU �il��� Bldg: sent rcv'd Valuation Site Plan: sent rcv'd Plan Check rcp # San: sent rcv'd _ Permit Fee Penalty Fee rcv'd Env. Hlth: sent — Eng: sent rcv'd Plumbing Fee FM: sent rcv'd _ Mechanical Fee Env. Cklt Fee TOTAL DUE: APPLICATION CLASTRUCTION INFORMALJN FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEW ❑ , ALTERATION ❑ , ADDITION ❑ DEMOLISH ❑ . Building Department �� Building Permit El Building Alteration Certificate of Occupancy ❑ Date��3 U_/L NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building / f �Q shall be issued until an application has been made and approved for a certifi- �[ Valuation based on total floor area $ / C� N O T I C E cate of zoning compliance. / / NV' POO A04i&A Where work is started (� //, Plan checking fee $ before permit is obtained ,Owner n" Address �� ����'�''�/ Permit fee fy $ s the permit fee shall '� U� be doubled. Permittee Address 1 � n 4.�i� Architect Address " Nb'I, SPECIFICATIONS Engineer _Address_ t� FOUNDATION _ 01 Exterior Piers COVERING Contractor _ Address Material _ Exterior walls �j Width at top Interior walls LEGAL DESCRIPTION OF PROPERTY: Lot No.__! 4 U Block No. Width at bottom Roof or reroofing �_Subclivision or Unplatted description �y u � ��/K/Ci�t7�'i/ __ Depth in ground ZONING INFORMATION FRAME Size Spacing Span FLUES TYPE OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W. Plate(sill) Fireplace proposed main building (circle) proposed main building (circle) Girders Floor furnace A B C D E F G H I J 1 II III III 1 hr. III HT Joist, Istfloor Kitchen DIVISION 1 2 3 4 IV IV 1 hr. V V 1 hr. Joist,2nd floor Water heater Joist,ceiling Furnace Use Zone Fire Zone Area of Lot Size of building or addition No.of stories Exterior studs Gas Oil Total height Basement floor area 1st Floor area Interior studs Additional floors and areas No. of rooms No.of families Roof rafters No.of buildings now on lot Use of buildings now on lot Bearing walls Percentage of lot covered by main building Additional Permits are required for: Percentage of lot covered by accessory buildings (check) IMPORTANT Kind of livestock ❑ Plumbing, ❑ Signs, ❑ Moving, Written authorization of owner must CHANGE OF OCCUPANCY from to— ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant If a commercial building,list each use and its area in square feet: ❑ Gas appliance and Gas piping. or lessor. I am the legal owner of the property described in this application. I hereby acknowledge that I have read this application and state that the above is correct and agree to comply with all city ordinances and State Laws regulating zoning and building — Owne DRAW on the reverse side of this application,to scale, a PLOT PLAN. APPLICANT PLOT PLAN FOR DEPARTMENTA6 JSE FOR DEPARTMENTAL USE Application for Certificate of Zoning Compliance ❑ Draw below,to scale, a plot plan showing: PP� g p Checked Initials 1. Dimension and shape of the lot. 1. 2. Front street name. 2. Building Permit ❑ , Certificate of Occupancy ❑ checked and approved. 3. Side street name if corner lot. 3. 4. Sizes and location on the lot of buildings already existing. 4. �n 4 5. Location and dimensions of proposed building or alterations. 5. Building Inspector_ xom h+/ Date 1-30 -� i 6. Front yard,side yard,rear yard setbacks. 6. Q r� 7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. 3� Date front yard trees and shrubs,green belt. 8. Location and size of required off-street parking and loading. 8. INSPECTION RECORD Inspection Date Signature Set Back Excavation Concrete Reinforced Steel Grout Blocks Bond Beam Frame Roofing Room Ventilation - �$ rw-r-r Kitchen Vent Bathroom Vent Foundation Vent Access Hole Garage Fireproofing Fireplace Spark Arrester Water Closet Water Heater Sewage Disposal Lathing Plastering Correction Order Left Stop Work Order Issued Stop Work Order Released Give brief report of special or unusual conditions Job completed A�ueDate !0 Building Wpector Certificate of Zoning Compliance No. Issued Date Certificate of Occupancy No. Issued Date MOORE BUSINESS FORMS INC,LA