HomeMy WebLinkAbout12 Betty Drive (7) TOT BIMI)ING INSPECTOR
of fur APPLICATION FOR
PLAN EXAMINATION AND
����COS. BUILDING PERMIT
IIAPORTA14T — Applicant to complete all items in sections: 1, 11, III, IV, and IX.
& HV I)r)"L)8 ZONING
1• AT (LOCATION)
OISTRICY
LOCATION ("0.) (STRCIT)
OF BETWEEN �16 • AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT—BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use
1 ❑ N w building Residential Nonresidential
2❑ Addition(if residential, enter nuanber 12&One family is❑ Amusement, recr ational
of new housirns units added. i/army.its 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 E] Wr citing (if multifamily residential. of units ——————— —i • ❑ Service station, repair goreg
enter number of units in building in 15❑ Garoge 23❑ Hospital, institutional
Past D, I3) 16❑ Carport 24❑ Office, bank, professional
6 ❑ M ving (relocation) 17❑ Other — Specify 25❑ Public utility
7 ❑ Foundation only 26❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercontiI
8 ❑ Private(individual, corporation, / 28❑ Tanks, towers
nonpr fit 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., fo d
processing plant, machine shop, laundry building at hospital, el m ntary
10. Cost of improvement............... school, secondary school, college, parochial'school, parking gerag for
deportment 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 ......................
e.Meeting, air conditioning.........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 17 O oc, ��E• �dp2
Ill. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Ports E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑Masonry(wail bearing) 40❑ Public or private company 48. Number of stories...............
31 ❑ W d from* 41 ❑ Private(soptic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32❑ Structural steel dimensions .....................
33❑ R inferced concrete H. TYPE OF WATER SUPPLY
34❑ Other — Specify 42� Public or privet*company so. Total land area, sq. ft. ...........
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosod ......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35❑ Gas Will there be central air 52. Outdoors.......................
36❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44❑ Yes 45❑ No 53. Number of bedrooms..............
36❑ Coal
39❑ Other— Specify Will there be on elevator? yg. Number of Full..........
46❑ Yes 47❑ N bethreems
Portion.......
IV. IDENTIFICATION — T b c mpl t d by all applicants
Name Meiling eddr ss - Number. street, city, and State ZIP code Tel. No.
jt. � !
�wner Or i
Lessee A jnb07V7L
1
(A �4(z i InU
2.
1 Contrac+or
3.
Arch,ract or
Engineer
The own r of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant AJJress I Applicati n date
00 NOT WRITE BELOW THIS LINE
iV. PLAN REVIEW RECORD — For office use
Plan Review .oats P!C-s Date Plans
Plans Review Required Check Fee Started By Approved my Notes
BUILDING $
PLUMBING $
MECHANICAL S
ELECTRICAL S
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit r Approval Check ObDto ed o to Number By Permit or Approval Check ObDained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING j
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS I
OIL BURNER WRECKING
OTHER I OTHER
V11. VALIDATION
Building /
Permit numb r 7,,-2 d'
Building Pe ///(�/ ��/
Permit issued (� 19
Building /Q�OD
Permit Fee S
Approved by:
TITLE
7S4.AAD. .S 9-oV7& -TN9►.w« ►b�.
INSPECTION REPORT
Permit #• Dl� Job 13E"I—r RI re-
1 Footing S�E1rE,l-�Q4 -
2 Foundation �bA oe
3 Framing
4 Wiring /DS1
5 Plumbing
6 Heating
7 Lathing Jf
8 C.O.