HomeMy Public PortalAbout4856 GOLDEN WEST AVE_Relocation__ APPLICATIO"I= --OR RELOCATION BUILDING PERMIT . J,
//,'�I'VX,9ION OF BUILDING
BDt[arD�,I,.N,�G� FET
AND SAY .
•f_� � 1D.t Of county Engin— -ADDRESS
County of.j.Ds-A g*lm
DDA.7_0
7e AWM• J..FOX, COUNTY ENGINEER LOCALITY '
7D
is-84 CASSATT D. GRIFFIN. SUr'T OF-BUILDINO NEAREST
CR06S 4T. -'
FOR "PUCAM M FAL IN DISTRICT NO. /QT��pUP TYPE CON
PROPOSED
BUILDING
ADDRESS j4i� '21 ' - MAP ATG .YGS O -
NUMDERHWY.
LOCALITY WU ZO E
SPCIAL
PRESENT CONDITIONS
BUILDING '
ADDREB
LOCALITY BUILDING YARD HWY STREET NAME WIDTH
SETDACK
FRONT
OWNER P. L —, ,
MAIL SIDE
ADDRESS P. L.
TEL '
CITY NO. SUn[TY C� DAT[ RlC'D
MOVING Y TEL d0 ; I Y
CONTRACTOR NO. _10 ncc'D
IL
ADDRESS
BUILDING TEL = APPROVALS
CONTRACTOR NO:
DATE IHSPECTOR'9 SIGNATURE
ADDRESS
FOUNDATION: LOCATION
PRESENT FORM. MATERIALS
USE OF
BUILDING FRAME: FIRE STOPS,
ERACING BOLTS
PROPOSED )a a. '
USE
OP '� FURNACE: LOCATION
BUILDING OA9 VENT DUCTS ,
qso LATH INT
SO. FT 'NO. OF ��-" r f
SIZE ROOMS STORIES LATH EXT. 3
WALL ♦tri RO F p HOUSE NUMBER COR-
COVERING (/ter..-UJ COVERING RECT AND POSTED
LEGAL
DESCRIPTION LOT NO. AL I BLOCK FINAL
TRACT rltl O/ DIST GINEER
NO. OF GS.
WORK COMPLETED f?
SIZE OF LOT NOW ON LOT SURETY BOND p
l�J _
USE OF I No,or RELEASED '
EXISTING BLDG. FAMILIKS . I HEEREBY ACKNOWLEDGE THAT, 1-fiAVE READ THIS
' HEREBY STATE THAT T 7
NF ION GIVEN IS COR- APPLICATION AND STATE THATHE AEOVZ Io CORRECT .,
RECT. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
RI '
SIGNATURE OF � �j/�A AND STAT[ LAW6 REGULATING BUILDING CONBTRUC-
.+
APPLICANT��A TION. - x
ADDRESS SIGNATURE OF�
PIRM}TT[[
VALUATION S P C_ s OC7
ADDR A/
t/00 -
FEE s
WIL1-IAM J. FOX. CouNTY FNGINQR �ALIDA
BYI "lltL'? b 6 4 9 A, A 1 .0�l --rY
DEPUTY DEPUTY
1_&2711T JnI O 6 A 6.00 N
BY By /
DEPUTY .,.A_J � f> DEPUTY