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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants '
No Mailing address — wnb cr, sirr'r-(, cif,,, utid ZIP code Tel. No.
/l
w or
L eilo 73
Les see e
Builder's
L. License No.
Contractor /
441 `
3.
Architect or — — ------
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this applicat on as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of appli t Address p Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
Permit number
Building
Permit issued 1977
Building
Permit Fee $ `1. 04
Certificate of Occupancy S
Approved
Drain Tile
Plan Review Fee S_
��,�' ® T I E
City of Xort4auiptou I r
t Office of the �ns}lertor of 'Puilbings
APPLICATION FOR
ZONING PERMIT AND
Page /0 13 Plot YO BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. Z
O
ZONING
I• AT (LOCATION) ' <?" OOl�l� ' 'd DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D m
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
1 LK New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12�<One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Past D, 13) 13❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — --)- 20❑ Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 F-1 Wrecking (1/multi/amity residential,
of units ——————— — -•1 22 ❑ Service station, repair garage
enter number of units in building in 15 5d Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional
60 Moving (relocation)
17 ❑ Other — SpeciJy 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
28 ❑ Tanks, towers
8 N Private (individual, corporation,
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ oo school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ ��41
III. SELECTED CHARACTERISTICS OF BUIL ING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV. D
O
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS M
48. Number of stories..............
30❑Masonry (wall bearing) 40 Public or private company
41 Private (septic tank, etc.) 49. Total square feet Floor area,
31 Wood frame p all floors, based on exterior
dimensions .......... /00
32❑ Structural steel
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft.
34❑ Other — Specify 42% Public or private company
........... �/19)0,Sl�
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
'O
51. Enclosed ....................... O
F .PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air
52. Outdoors........................
conditioning?
36�,Oil L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44❑ Yes 45 X No 53. Number of bedrooms.............. 3
38 ❑ Coal
39 X Other — Specify 1 a I Will there be an elevator? Full.....�....
54. Number of
bathrooms
46 ❑ Yes 47 No Partial...(.... I
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
Z D
4 -- ' BUILDING <a
PERMIT
VALIDATION
DATE May 26 197_ PERMIT NO. 1'!9
APPLICANT Kenneth W. LyndS ADDRESS �9 Austral Terrace Apt s.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF 1
PERMIT TO NeW Residence ( 2 ) STORY Residence DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) R gP_ry!Olx Road DISTRICT RR
(NO.) (STREET)
a BETWEEN AND
b (CROSS STREET) (CROSS STREET)
LOT
a
IL SUBDIVISION LOT BLOCK SIZE 1.77 acres
t
V O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
M
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
It
O t-w nrnc_f-gm-ily reside
E- REMARKS: �y(]nC 'Y'71('.t ^- .nC`P
VOLUME ESTIMATED COST $ 18.000.00 PERMIT _54.00
(CUBIC/SQUARE FEET)
OWNER xenncth & Karen T,Y,.]2(i,c r
BUILDING P
ADDRESS 19 A ustz'a l Te=a c.P Apt s ,S autha min BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)
ow