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APPLICATION FOR BUILDING PERMIT 1
DrMON OF BUMMIG ASAFETY BUILDING
ND
AD REtD
DOpeI of COInIY ED
CO°OlT Of Lot AngdtO LOCALI
WM J FOX COUNTY ENGINEER NEAREST
CAGSATT D GRIFFIN SGF T of BUMOING CROPS
FOR APPLICANT TO FILL IN
DISTRICT N0. G M[ Alk
eEW ER Yl1r
BUILDING
ADDRESS 5 EJ N MAP
BER °THS YEt rNODI
LOT NO BLOCK OYEZ N[ SPECIAL
14 /flJ._ CONDITIONS
TRACT '
'34
BIZ[OF LOT X I NOW ON LOT UILDING YARD I HWY STREET NAME . EXIST
{ �_1� 'r SETBACK WIDTH
-VSE OP- -—CIA A. `- -CIV/N--- - - - -FRONT O /
NOR P L
OWNER A 12 L LID[MAIL
ADDRESS O P CJjY L O TRACT DWELL. `it UNIT 1
S INDUSTRIAL
G No TE- I DWELL I UNIT B PUBLIC BLDG
ARCHITECT ON Tat. 2 DUPLKx / IT'1 UNIT
7 .ALT ETC
ENGINEER NO 9 APT .�VNt
B MISC MItC6
DO EDB 4 CONM[RCIAL
CONTRACTOR COOS INX.
1�TNO
EL �^ DWE=ON RECORD
ODREBS 2oaVkEAb
DESCREMON OF WORK
NEW X ADD ALTER REPAIR DEMOLISH 1
Ufa a
°G PI' olO OR NO-OF—
BIZE ORIEL FAMILI
USE OF STRU UR 1 ... IT'
T 0, J,—i Y✓—
SIGNATURE OF
ALICANT
PPAPPROVALS
ADDRESS DATE NfifECTOR E SIGNATURE
FOUNDATION LOCATION
��'���III///��y P C t FORMS MATERIALS C
O D FE[ FRAM[ FIRE STOPS /
VALUATION t " BRACING BOLTS L1
FURNACE LOCATION
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAB VENT DUCTS
APPLICATION AND STATE THAT THIS ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT c _ S'1 LAI,a�IYwJ
IO
TN STATE LAWS R LATINO BUILDING CONSTRUC-
T
- 4
/ ) AA LATH EXT V
°1OPERMMIIT[[ � 7 �i 1 HOUSE NUMBER
POGTEDR IIJ 4SZ
woonsee FINAL T �
WM J FOX,COUNTY ENGINEER VALIDATION C. N DIRLAM. CHIEF BLDG INSPECTOR
L, ; 8005 k',,f 9 1 6 1R):O4D; NN 14 1 2200