Loading...
HomeMy WebLinkAbout028-260-038 028-260-038 04-2439 RUSSELL, ALBERT 5654 LA PORTE RD, BANG I AL Cont OWNER DEMO (GAR,HOUSE,SHED BUTTE COUNTY DEPARTMENT OF DEV�LOPMENT SERVICES BUILDING -PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 5384541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.neAdds PERMIT NO. BP042439 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date' 08/18/2004 APN-- 028-260-038-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 5654 LA PORTE RD BAN Date: Contractor. Map Index: Di:scription: demo (gar, house, shed some outbuildings) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the , Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: ALBERT RUSSELL DVISON III permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 7 DOGWOOD NORTH the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or IRVINE, CA 92612 she is exempt therefrom and the basis for the alleged exemption. Any (949) 322-1301 violation of Section 7031.5 by any applicant for a permit subjects the f applicant to a civil penalty of not more than five hundred dollars ($500).): f 1, as owner of the property, or my employees with wages as their y1 sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions .Applicant: ALBERT RUSSELL DVISON III Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 7 DOGWOOD NORTH provided that such improvements are not intended or offered for IRVINE CA 92612 sale. If however, the building or improvements are sold within one i year of completion, the owner -builder will have the burden of (949) 322-1301 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as, owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business ! and Professions Code. The Contractors' State License Law does I. ontractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Fxerppt under Article of th B sill �a essions Code Date: Owner:...., 5%�/ License #: WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: O 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: [ V Cartier:' Total Square Ft: 0 S. F. Valuation: $0.00 Z9�Policy#: , I Census Code: I certify that in the performance of the work for which this.permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' ! j� compensation provisions of Section 3700 of the Labor Code, I shall forthwith c mply with those provisions. Date: Applicant: i WARNING: Failure to secure workers' compensation coverage,_ is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided,for.in_ Section of the Labor _ — - , ,I\ �► 'ly"�' code, interest, and attorney's fees. '0G.; j'�] CONSTRUCTION LENDING AGENCY This permit i ereby is/sued under the applicable provisions of the Butte County Cody and/or I hereby affirm that there is a construction lending agency for the Re otie ' to d ork indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) / By: Da Name: Name:- PERMIT EXPIR S N: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby for inspection authorize representatives of 13utte County to enter purposos. ru/upon thP above mentioned property �� v Signature: 7f4/pINIJJ Print Name: a Date: i Owner O Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds PERMIT NO. BP042439 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 08/18/2004 APN: 028-260-038-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 5654 LA PORTE RD BAN Date: Contractor: Map Index: Description: demo (gar, house, shed some outbuildings) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: ALBERT RUSSELL DVISON III permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 7 DOGWOOD NORTH the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or IRVINE, CA 92612 she is exempt therefrom and the basis for the alleged exemption. Any (949) 322-1301 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: ALBERT RUSSELL DVISON III Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 7 DOGWOOD NORTH provided that such improvements are not intended or offered for IRVINE CA 92612 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (949) 322-1301 proving that he or she did not build or improve for the purpose of sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, " and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ lam Fxerppt under Article of th B si e, a essions Code Date:e/aw Owne.: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier. Total Square Ft: 0 S.F. Policy #: Valuation: $0.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith mppllly with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred%thousand dollars ($100,400), in addition to the cost of compensation, damages s provided for in Section 3706 of the Labor ^J{� code, interest, and attorney's fees.- ees. CONSTRUCTION LENDING AGENCY CONSTRUCTION This permit�,iskereby issued under the applicable provisions of the Butte County CodW I hereby affirm that there is a construction lending agency for the Re to d ork indicated above for which fees have been paid. C performance of the work for which this permit is issued (Sec 3097 Civ.) ' / Q /S Name: By: Da �� Address: PERMIT EXPIR S N: (D ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of 13utte County to enterupon above mentioned property for inspection purposes. �th� Print Name: �1 7�� `� Signature: Date: /Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE UNTY O�uTrF0 DEPARTMENT OF'DE EOLOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION . 0 0 AND SUBMITTAL REQUIREMENTS 0 0 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 0 0 OFFICE #: (530) 538-7541 COU N'�� A FEE WILL BE REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" APPLICANT NAME OWNER Last Name UCS City irstNamm .4- Address City City ." State State Zp Phone _ 3Z -I D FaxE-_ 9* 7-/Z mail Lic. # APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State. Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X 40t4w"4ff -,;,. I For office use only: Zoning Property Address 14 Flood Zone Cross Street SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. FIN BIN # LOCATION AP# Q _ G Property Address 14 City 1 Cross Street WORKS 'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY' Name Address Description or Scope of Work: Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the'date of application. In order to renew action on an application after expiration, a new application, plans and fee will be OVER FOR SUBMITTAL REQUIREMENTS 11 K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount ✓ Bldg SRA Receipt #: — I Sheriff SMIP 6—Other c Total REV 7-27-04 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit.. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND /N INK ❑ 1 Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6._, Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. - ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, -(C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). = ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. . ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional, information regarding this process, contact a Permit Application Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a pen -nit has not been issued will expire one year after date of application. In order to renew action ori an application after expiration, a new application, plans and fees will be required. - REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request'm' dst be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING FORMS\BldgApplSubRgmts.doc Page 2 of 2 REV 7-27-04 11 Demolition Permits Asbestos Notification Statement' Date —O" AP# 079?,�O 3 Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form: "19827.5. A demolition permit shall not be issued by any city, county, city and county, or state and local agency which is authorized to issue demolition permits as to any building or structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit appli— cation." Attached is a copy of my written asbestos notification to the United States Environmental Protection Agency for the demolition project located at Signature of Applicant OR I hereby declare that a written asbestos notification to the United States Environmental Protection Agency is not applicable to this demolition project. Signature of Applicant 2/19/91 O.B.-1 OWNER -]BUILDER VESICATION Attention Property Owner: An "owner-bvildee' building permit has been applied for in your name and beating your side. Please complete and retain this information at your earliest opportunity to avoid unnecessary delay in processing 'and issuing your building permit No building permit will be issued until this verification is received. I personally plan to provide the major labor and materials for construction of the proposed property ' rovement : YES NO ❑ IHAVW,q HAVE NOT ❑ signed an application for a building permit for the proposed work. I have contracted wiA tbp fpllowmg person (fum) to provide the proposed consirvction: NAME: �{ ADDRESS: CITY.. PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work NAME: ADDRESS: - CTIY:' PHONE: CONTRACTOR'S LICENSE NO. the work indicated: NAME ADDRESS PHONE TYPE • OF WORK, SIGNED: PROPERTYOWNER: DATE: NOTA: This Owner -Builder Very7m on is required by Section 11831 and 19831 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OWNER BTIIIIDFR INFORMATION Dear Property Owner. AnaPPi ma for a bml&g pew has been submitted in your name liskag yourself as floe bmlder of proPatY rovemenfs speoffi For your Protection, You should be aware that as "owner -builder' you are the mLZle a permit Building pemuts are not rupfird to be signed by pro f P�3' ofrecord on such own worm If your work is being performed per' ° unless they are personally performing their liability if that pm -son. �` SO�O� other than yourseLy you may Protect Yourself from possible P applies for the proper peamrt in his or her name. Ca *actors are repaired by law do be licensed and bonded by the S[aie of Carnia and to have a business license from the city or coumiy, They are also required California by law to pint their license mm�ber on all pet m for which they apply-Ifyou plan to do your own wor>� WA the =eption of various trades that you' to subcoatract;,,youi should be aware of the following �ormahoa for your benefit and protection: ? If yon employ or otherwise engage any Persons other than your immediate may, and the work (mchhding maiarials and corer costs) is $300 or more for the entire project; and such persons are not licensed as congnmtrs is snb� then you maybe an employer;or ♦ If your are an employer, you mast register wi& the State and Federal Go vemments subject to several obligdhons g state and Meral income tax wifho as as employer and you are woi3cers comPeasahan iasr:��, dye Wmg federal social security mss, ♦ There may be financial risks far � ice costs, and Ioymeimt compensation confizbufions. with ecu to workers j'OII if you do rot catty omit these obligations, and these risks are especially serious �P 'compensation iasunance. ♦ Far more specific inion about y= obligations under Federal Law, if yon wish, the U.S. Small Basiuess Adm.. . co�ract the intemai RBvesme Service (and, Slate I,aw contact fire D mus oa)• Far more sP'„cc fi&nnafion about your obligations under epartment ofBenefit Paymeuis and the Division of industrial Accidems. If The st MCtme is intended for sale, property own= who are notwork licensed conditions. na>ly their own employees, wishout a licensed co &wtor�subcontractor, allowed are , mer 1��td Afrequent practicce of unlicensed persons PTOhssing to be coairacbars is secure an "owner builder" b P , won=* hv� that The PrDPMty owner is pm�g his or her own labor and building permits are not required to be signed by owners �� ply' B. infi3ahm about h nsed P obtained by are g Tzer own warm peasonaii3 fifty or at 1020 N Std Sam CA. 95814. cmgrd=g the iia State License Board in your Please couplets the "Owner Builder Verification" on the reverse side of this form so That we can conf r n that you are aware of Shwa maters• The building P=* Will not be issued mgfl the verification is returned. VOZZ• Z7,is 0M. er--8,ffd4 r fyrfprl!awn is requ&a1► secdon I483a offlue Cworjda H=h* olid SVIV COdC �Z RURAL PROPERTY APPRAISAL RECORD t 1YAMSACTIOM RECORD Date 1, R. S. Tr. Deed n ico a Grantee F Price L a�'-�� ry Remarks 1-r1r." 1 1 1 Year ' Appraiser Dale Structures Replacement Cost Structures R C. L. Al. D. Land Value and Vine Value Lon_ and Improvement Total Capitalized Earning 'Ability Indicated Sale Price Listed Price Total Value R. E. Land Value. Strvctures Value Tree and Vine Values Land Structures Tree$ and Vines Total l�— r 1 1�1i'1s SHEET SUMMA /G 19 - / 161 Soles A— Code: APpro.se, No: aee v 163 ne Iomple,e,' P.U. 19......... 164. Zoning: �'e1C 165 Zoning Conto.m.., Yes'0— No ' ZED O ; �lje' Confo.mllY: Yep©�'�Na ' 167 -20600 ' 168 BR: 13-2 3 O 4 O 5 ❑• 169 8alhs: I ��2 Q• 30 ".0 �, Q 170 171- . Fir 172 Land' Type: Loi [?I— Ac.rogo 173 Ge.age: Yos O-- No 0 !jmPTT.prmn Pool: Yos No fn— A L 7C) 0 _ DSD : ,.. ASSESSED VALUES `5 F -)o, } ~ Yv 19 /9 A. P. N. BooF Pogo Pe.col /9 , ' SHEET OF 2 ' 160 Use Code: - / 161 Soles A— Code: _ 162 APpro.se, No: aee v 163 ne Iomple,e,' P.U. 19......... 164. Zoning: 165 Zoning Conto.m.., Yes'0— No ' 166 ; �lje' Confo.mllY: Yep©�'�Na ' 167 Bldg. Close: ' 168 BR: 13-2 3 O 4 O 5 ❑• 169 8alhs: I ��2 Q• 30 ".0 �, Q 170 171- Amo: Fir 172 Land' Type: Loi [?I— Ac.rogo 173 Ge.age: Yos O-- No 0 174 Pool: Yos No fn— Area No. Type Index Top. Era. Alk. Acres Acre uiv. — 9 Use Production — Remorks,.. /9 _ V/A To to/ i p p i AA/n v.e / /ix'e Area l9 t'- Acres No. VIA Total 196 VIA Total 19 19 /9 19 /9 /9 VIA Total VIA Total V/A Total V/A Total V/A Tolal V/A Total /9 _ V/A To to/ i p p i 1 rr C C. GR Y I IV C UA / A Physical Condition — Production — Remarks :�• / r/ ! rC'C:rtf E,.,:t;'"r ,a rre-JIUr_IV I IAL' hVILL)ING RECORD �- - ,. �S l.4°`.e..-dt F)'"r,��'/�' t� rl�i• i �4 50081 ri J,��.,.,�..�.�' P,�RCEL ,> .i 1 nit Cost Cost �'t"F:id�?a�! .t ?, Cost nil Cost ADDRESS 0 os/ SHEET r OF - �' SHEETS DESCRIPTION OF BUILDING --- '--------_._.__ {,Q SHAPE CONSTRUCTION STRUCTURAL EXTERIOR ROOF LIGHTING _ AIR CONDITION r Light 9 u y. /( n From 1 . Stucco on Fmt I Pitch Wirin 9 Healing 'ARCHITECTURE Sub - Standard Gob/c / /� /C Coo/in ROOMS Standard Sheolhin 9 4 n j �Lte�:(.a.. /tip _•. T. Conduit Forced /eom Above -Standard ConcrefeBlock r l t' CA':�E>c 1 Shcd / 8 X. Coble Fixtures Gravity Humid All Stories Jpecia/ B.B B. T. B G. Cut Up Few Cheep Wo//Unit USE TYPE i Brick Shiny/es Dormers AV . Medium ' floor FOUncrete N Adobe Spokes it` .1/ • Mony Liviny Double Concrete Floor.Joist: B$B. r 6.. Gutters Specie/ Zonelinif Dinin 9 ' Duplex Reinforced �/ .rt _ f :J'xl-1 ; PLUMBING Centro/=• 1 - Brick Shiny/e Poor Good Bed2nd:X 7'"Bed Wood Sub Floor Slone Shake ._, Piers WINDOWS Ti/e/ D.H. Cosemenf Tile Trim 6Woter1y'eoter I �) Units Li ht Insulated Ceftin s Slee/ Sash Composition Autamofic Firep/ace Kitchen �•� t-• .. Heov CONSTRUCTION RECORD Insulated Walls Screens Compo. Shin /e , Gas Elect. DrainBd. �� 7r�oternatr �------- _..._-...__,_... eFA/�� Permit EFFEC. APPR. NORMAL % GOOD RATIN.G (E,G,A,FP) _ Amount Dole YEAR YEAR Age Remain' y Too/e % Cond. Arch. Fanc. con- Stora eSpoce Work- BATH FINISH DETAIL I rVo. For Life F/. No. �tr. P/oJn form. up6dC/osef hship FIXTUR S SHOWER F/Dors Wo//s WC. Lo. ub T Grade ���� r / 7 �/ {, c.}1 • pe t. T. .D. Finist 1 - _ 1--��.• -..�.: � �'c7-'1._ n D 4�.w t1,�f, - �( 4 '. I ` . r = n TOTAL NORMAL ala GOOD R. C. L. N, D. AH 530-A I l d3 s✓s ) r� t �3 _G4 1 <7 _2/6O I 1111 1 11FT_ SPECIAL FEATURES Book Cases Buill -in Beds Venetian Binds nig OS/ nc COS/ on51 COS/ rrnel COSI 0 CUPIED • REN ,. �- COMPUTAN Appraiser & Dole z?- - �- / �_r , l� �_ 50081 Unit Area Uost Cos/ nit Cost Cost Unit ost .t ?, Cost nil Cost t os/ TOTAL NORMAL ala GOOD R. C. L. N, D. AH 530-A I l d3 s✓s ) r� t �3 _G4 1 <7 _2/6O I 1111 1 11FT_ SPECIAL FEATURES Book Cases Buill -in Beds Venetian Binds nig OS/ nc COS/ on51 COS/ rrnel COSI Structure Found Cons. Ext.' Roof Floor Int. ' Size etc. ,4-, f -.. i 'C._T-�,�� .. . T' I: !�- � �•-, .. ._ ..._. •roc _ 4 COMPUTATIONS }T} � 1 ,4-, f -.. i 'C._T-�,�� .. . T' I: !�- � �•-, .. ._ ..._. •roc _ 4 }