HomeMy Public PortalAbout10638 FAIRHALL ST_Building__ DEPARTMENT OF COUNTY ENGINM
DMSIO COUNTY ODIN AN SAFETY BUILDING -
WILLIAM J. FOX, COUNTY ENGINEER APPLICATION
CASSATT D GRIFFIN, SUP'T OF BUILDING 1 1
FOR APPLICANT TO FILL IN 1 FOR OFFICE USE_ONLY
BUILDING ! DISTRICT NO 1 PLAN CCK OR REc No PERMIT NO)
ADDRESS e.. Q V k 'f 47- 7 / 2 01— 2 p
D
LOCALITY �� � ,��/[V�/R'//,,ECEIVEDIBY � DATE OF APPL DAT IS3 ED
NEAREST '1/1.14 '/'o A,//6��� 11 O �3
CROSS T / / ��oo BUILDING '
OWNER 4.MAILaI cAl,L ADDRESSI t J 1 1
ck
ADDRESS / ./s� ��/"l (04�. LOCALITY ��
/} NEAREST
CITY P (r"�Q��" TO �'�� j CROSS ST
ARCHITECT OR TEL ZFIREONE # I PLAN$ ih TYPE- GROyP; -
ENGINEER NO �CCLL�r
BLDG Oft O
ADDRESS SETBACK,LINE' �6 i/Q ' I / ,
L. NO ��TEL USE APPROVE /i '�- :57
CONTRACTOR r ZONE GCJBY !/ 1 /L ATE
ADDRESS H E NUMBERING i
f
LEGAL / MAP NUMBER 26/d NO ASSIGNED BY
DESCRIPTIO LOT N BLOCK
CORRECTIONS
TRACT / 1
/ LD
=SIZE OF LOT -(I V O NOWNOOF ONBLOTG.5� ' L.
USE OF NO OF
EXISTING BLDG FAMILIE -
D ON OF WORK o —
NEW ALTERATION _I ADDITION
Z
REPAIR DEMOLITION Y
r
SQFT NO OF
SIZE I D 7 ^ ROOMS p STORIESEXT WALL V 1�
COVERING 1�C`' D I COVERROOF ING CD W O-
USE OF STRUCTURE
� _ � Ria- � •� yo -
APPROV LS
INSPECT R'9 SIGNATURE DATE
/na FOUNDATION LOCATION
FORMS, MATERIALS /_ 4 se., Ile-1�r'
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME FIRESTOPS
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTSigyl.
CORRECT -
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION ��
AND STATE LAWS REGULATING
BUILDING CONSTRUCTION GAS VENT, DUCTS
SIGNATURE OF /�/ C/j/�� LATH, INT 1 v`A
PERMITTERL� �Z
ADDRESS
Z /�H �� LATH EXT
J ,�' 7
PLASTER, INT
AUTHORIZED AGT
PLASTER EXT
P C $ ,
1 G o HOUSE NUMBER COR-T
FEE / �' RECAND POSTED ' / 1 Jill
VALUATION Q U v FEE S '^—`FINAL '
76AG38A 0893 9-91II