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APPLICA'1 0t'4 %:ONSTRUCTION INFORMATION
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEW ❑ , ALTERATION ❑ , ADDITION ❑ , DEMOLISH ❑.
Building Department
Building Permit Describe Alteration
01
Certificate of Occupancy ❑ Date �U—�� --�� �� �r/ P' LZ1117,J
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building O�
shall be issued until an application has been made and approved for a certifi- Valuatio based on total floor area $''5no• N O T I C E
cate of zoning compliance. Where work is started
Plan checking fee $ before permit is obtained
Address the permit fee shall
Owner Permit fee be doubled.
Permittee Address i J
Architect Address
SP-
ECIFICATIONS
r
Engineer Address
FOUNDATION Exterior Piers COVERING
Contractor Address Material Exterior walls
0Width at top Interior walls
LEGAL DESCRIPTION OF PROPERTY: Lot No. �+�— Block No.
� "I-, �� �1� Width at bottom Roof or reroofing
Subdivision or Unplatted description C.r J]X/
Depth in ground
'i&�U i& INFORMATtI'OC.�N 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 11 III III 1 hr. III HT Joist, 1 st floor 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
Owner
DRAW on the reverse side of this application,to scale, a PLOT PLAN. APPLICANT
PLOT PLAN FOR DEPARTMEK L USE
Draw below,to scale, a plot plan showing: FOR DEPARTMENTAL USE Application for Certificate of Zoning Compliance ❑
Checked Initials
l. 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. F�
5. Location and dimensions of proposed building or alterations. 5. Building Inspector Date
6. Front yard,side yard,rear yard setbacks. 6. 1 7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. ®� —Date 'U-
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 111
Bond Beam
Frame
Roofing
Room Ventilation
i
Kitchen Vent r g
Bathroom Vent
Foundation Vent
Access Hole 6 l�
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 � "�1 Date �r 3'�
Budding Inspector
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC.LA