HomeMy Public PortalAbout5325 PAL MAL AVE_Building__ 19ACi9AC[#003-IOee APPLICATION FOR BUILDING PERMIT 1
BUILDING AND SAFETY DIVISION BUILDING
OCfQ inient of County EnglBam ADDRESS 1
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County of Los 11D9alas Locwun
JOHN A LAMBIE, COUNTY ENGINRIER NEAREST
CASSATT D GRIFFIN SUP T OF BUILDING
FOR APPLICANT TO FILL IN DISTRICT NO OUP nP! HEWER MAP
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BUILDING
ADD REBS �s STATISTICAL CLASSIFICATION
LOT NO BLOCK CLASS NO DWELL UNI.fS
LOT NO BLOCO
MAP STATE YESNO
NUMBER HWY
TRACT 4IJ9 USE Z NH -SPECIAL
.Py. NO OF BLDOH CONDITIONS
81ZH OF LOT O I NOW ON LOT 7/
EXIHTIN BLDG S gU1La�O IXI9T
A. SETBACK YARD HWY STREET NAME WIDTH
OWNER F FRONT iL
MAIL P L
ADDRESS sr SIDE
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ARCHITECT OR TEL INSPECTION RECORD
ENGINEER NO
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TEL
CONTRACTOR =r
NO
DDRESB
DESCRIPTION OF WORK
NEW A'ADD ALTER REPAIR DEMOLISH
6O FT o NO OF NO OF
BIZ! 82__ STORIES FAMILIES
USE OF STRUCTUREfffrL
APPROVALS
SIGNATURE OF
APPLICANT DATE INSPECTOR SSIGNATURE
ADDRESS FOUNDATION LOCATION
FORMS MATERIALS
S p C B �/ FRAM! FIRE HTOP9 / /
7�D0 REE A7 BRACING BOLTS
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VALUATION FURNACE LOCATION
REE Q GAS VENT DUCTS
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT 7
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND /
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH EXT
STATE LAWS REGULATING BUILDING 5
NSTBUCTION
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED p
ADDRESS FINAL
JOHN A LAMB COUNTY ENGINEER CLYDE N DIRLAM PRINCIPAL STR URAL ENGINEER
FLAB C!$C[ VALIDATION 69 N o usH PEHLQT VALIDAT[OH cK M o unx
LACo3 54 61�, OCT 21 1 6 1 1 .7 5 12 �µ '
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