HomeMy WebLinkAbout121 HALLER AVE_2871_2026 APPLICATION C_ NSTRUCTION INFORMA • .3N
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEW ❑ , ALTERATION ❑ , ADDITION ❑ , DEMOLISH ❑ .
Building Department
Building Permit Describe Alteration__ .G
Certificate of Occupancy ❑ Date_ _ `0 - 1
NOTICE: No permit for erection alteration moving, repair or occupancy of any building
shall be issued until an application has been made and approved for certifi Valuation base on total floor area � �� N T I
pp pp u d f a 5 O C E
cate of zoning cgiipliance. Where work is started
Plan checking fee $
-` before permit is obtained
the permit fee shall
Owner - � _�[�P_'_,._---�-_� Address �a� ( ' % X- Permit fee $
_ be doubled.
Permittee_ U Address
Architect Address
SPECIFICATIONS
Engineer Address
FOUNDATION Exterior Piers COVERING
Contract Address
Material Exterior walls
— Width at top Interior walls
LEGAL DESCRIPTION OF PROPERTY: Lot No. b-� Block No.
1 Subdivision or Unplatted description Width at bottom Roof or reroofing_
j40&9 Depth in ground 16
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 ►II III 1 hr. III HT Joist, 1st 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- 1 st 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 building4__ — - 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
I hereby acknowledge that I have read this application and property described in this application.
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 DEPARTMEN, USE
Draw below,to scale, a plot plan showing: FOR DEPARTMENTAL USE Application for Certificate of Zoning Compliance ❑
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 ctrid_16c6tion on the lot of buildings already existing. 4. ig,4t,
/ ��
5. Location and dimensions of proposed building or alterations. 5. Building Inspector Date/
6. Front yard,side yard,rear yard setbacks. 6. +3�
7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. Rj
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
r."
Excavation
Concrete
Reinforced Steel
Grout Blocks
Bond Beam
Frame
Roofing
i�
Room Ventilation
1 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
Building Inspector
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE RU SINES FORMS INC AA