32A-138 (19) " — DEPT. FILE COPY
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BUILDING <<
J C (PERMIT
VALIDATION
�. DATE Lu KL /G 197 PERMITT NO. £0
APPLICANT Car Et Ki Ova ADORGSG"3 f^7F�R�{/EI ...s,77
(NO.) (STREET) (CONTE'S LICENSE/
.. 'D / TT r NUMBER OF
PERMIT TO (____V STORY DWELLING UNITS
/(STY(PEE OF IMPAOY£MEND a TNO. (� ffyr�I� (PROPOSED VSEL
AT (LOCATION) `T $9� A A43 —r N'qM p No r4 .._ ZONIDISTNG .3
(NO.) (STREET)
o BETWEEN AND
(CROSS STREET) TCROSS STREET)
LOT
m SUBDIVISION LOT BLOCK SIZE
o BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
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2 TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
IL REMARKS:
ren.+..a N DIM'RE
AREA OR pp {�
"SME ,� ESTIMATED COST �p �`� -a`0$ FEEMIT . 0 u
LCUBIC/SQUARE FEET)
LL �A t BUILDING OE-t. /
.Pil M/ws+�i 8Y /
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(( (Affidavit on reverse side of application to be completed by authoriz-. •ent of owner
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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) (STRfE7) - (CITY)
APPROVED BY TITLE
DATE 19_.
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name
2. Ownei s address Main
L .._....._...._._.. . __..._.:.................._._................__.....__..._._
3. Architect's name ....
4. Builder's name •
I
5. Builder's address I
6. Location of Building• Street No. _.._._.,:.._._F:.._:._:..__...s...:... ............l_:._..:._.._.:...........__.._ __........_...__..__.
7. Is this a removal or new building
8. If removal, from where
9. What is the purpose of building ....J
10. Material of building IT_ . f f +
11. If a dwelling, for how many families_ Number of rooms
12. Is there to be a store in the building....`{:. _
13. Size of building, No. of feet front No. of feet deep ; No. of stories _.._..�.._..
14. Size of ell, No. of feet front • No. of feet deep ; No. of feet high .....
15. Size of Lot Feet Wide ._.._ Feet Deep _.._..
16. How near the line of street __...._..._.
17. How near the line adjoining lot. Right.. ..eft ; Rear .........._..__..._....__
18. Nearest building is feet in a direction .. _..._
19. Material of the floor
20. Size of timbers, 1st • 2nd ..........._...._..... ; 3rd .. ; 4th • 5th _..._........._...._...
21. No. of feet span ; Distance on centers
22. Will the building be erected on solid or filled land
23. What is the material of foundation_..._._........_............ Footing - --•— - _
24. Will the roof be flat or pitched Covering.............._..._...._.........._._...._...._......_......
25. Heat; steam, hot water, furnace, stoves ' Power oil burner
26. Fireplace ; Insulation
27. How many sinks • Toilets ; Lavatories ... • Bathtubs....._..; Showers • Settubs
28. City Service; Water Sewer ; Road Surface ; Sidewalk
29. Is lot on accepted street
30. Estimated cost (must be filled out) -
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
Signature of applicant .....
_ REMARKS Na....i..._d .._
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