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VUAOl OP ORONO MNUNNG PfllMIT <br />PURTOSI OP MmOMa n <br />worn NO. <br />S«c. No. <br />//pMOyMO. >^7:3... <br />PBMMT NO 1616 <br />Hi7^ <br />lot J^lock Addition or Subdivision <br />4/C fft-S iq -i~ <br />Sin of Lot <br />Land Sq. <br />Elovotion <br />^ ^ 1/\. Ft. S <br />■UaWMO LOCATION <br />Oi*. From toad <br />Dit. Sidos <br />Dit. lock <br />Drolnogo <br />coNsnucnoN <br />From# <br />Stucco <br />Stono <br />Brick. Solid <br />Brick Vonoor <br />Comont Block <br />FOOTMOf <br />Dopth ^ <br />Width ^-yjo <br />Loott Dopth j' ^ <br />BolowGrodo ^ <br />POUNOA1ION . Construction <br />FloorCround Oroinego <br />Boaring Foots Sin Spacing <br />Boams Sin Span <br />^4 |SNo. <br />Foundotio <br />Hoight Abovo Roof <br />Smoko Pipo—Oistonco From Joists <br />NO. OF NREFUCfS. <br />Typ* <br />Joists 10 Sin Span * ^ , <br />Spacing I fr Bridging .v... <br />Booring <br />trUOINNOS <br />Sin avV <br />Spacing 1 Cr- <br />Platos <br />CnUNO JOISTS . <br />Sin <br />Spacing T Spacing <br />Span ^ Longest Span ; <br />Broclng“Tr^^^^ <br />EXITS <br />Banmont <br />1st Floor — N.. to <br />Stairway l{ <br />Stairway <br />INSULATION ~ Coiling <br />VDmATWN AMO UOHT <br />Forcontogo of Floor Aroo Vont. <br />Percontogo of Light to Floor Aroo <br />imras <br />Sin Span f ^ <br />Wm TYFf <br />Construction »v 4-5 ..<5.1^ <br />Locotion <br />SIFTIC TANKS OR MUMOFAL HOOKUP □ <br />Sin <br />Distonco From Woll P / ^ <br />Construction c- / 3 <br />Dopth <br />Width >' __ <br />Length \yh <br />Distance From Well ^ <br />Distance From Lot Linos <br />FLUMBINO FIXTURK <br />Gsrbage Disposal / <br />Sinks I <br />Laundry / <br />Both Tub I I <br />Dish Washer I <br />Shower / * <br />Toilet / J I I <br />Lavatory / I I / / <br />‘'-C <br />4(L^'r <♦ <br />Date__6./"^ Y/ ^^ <br />Bldg. $/i> ^ Plumb. $______ <br />Site Examination $_______Well $_ <br />. Sewoge $_ <br />PLUMBER. <br />ADDRESS. <br />WELL PPIHgQ \a/j^ <br />ADDRESS____________________ <br />SEWER CONTRAaOR___ <br />ADDRESS__________________________ <br />Approved.