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» aw f "i' r" f t;aEMAL, Nt)U31Ntt AOWINItTpATItie iPcirro APPOIl d "
`w r twos accurate register of carbon copies, fosses Omni ties• d,3..�gOSS
F Dorm 2005 may septiraad &ton{ above fold. Staple
,t x. VAForni 36-'[8�4 d
a` completed Cheats ro`ether to orlaln&1 or e,
4/73
p� *R�y e�
#+ OSBC� CtJ113frOl r iclt) ��5C�IP 0 IO OF �� i � �� �O.r (Tp the ioseruw 6Y FHh of YAr k
. Prow
p undoir Constru iory
4' IN �/ LA � City r�urr star.
Froprsrty Qddr®ss �---
G� E
.A
Mortgagor, or Sponsor i;varr►e)
Contrat:tor or Buildtlt (Name)
ed INSTRUCTIONS'; '
ceell
1. For addirlonal lnfornaflon on bl thin form is to bs submitt r q ed, then the Minimum acceptable, will be ossumed. Work o"dooarlbad.
Pp or minimum re uiremorl cannot be considered unless speclflcolly
;' to at copies, etc„ see he lass+uctlone a licoble to the FHA ApPlicatian t 4, lnclu�yy
! „ Alottoope Ineuronco, r VA Request Far Determination of Reasonable.Volus,os (Consideration of atM quosf+forracesptoncorof substitute matieriarlalot!qulP•
the case may, he. '
7, bil lbe all materials and equipmant to be used, whether or riot shown mon5,i Include sign ureaurrequired of the end of this form.
k; stir drawinpsrbY marking an X In •qch appropriate chetk•box.- and entering the �� Ilonce with the related '
ppel I.
space , n shall be completed In comp
inlnrn+arion nd for in each o an attachr+dsi+oet ri1E is USEnterGN'F'AItJTSao mist."
GON• drawings and spetlFiicorionsr oa amended during proee.aslny.. The stinum
and desel under item 2i or, n cations include this Description of Mbterlais rand the applicable Minimum
`
TAMING MORE THAN ONE PERCENT LEAD BY WEIGHT IS PROHIBITED. �
i', 3, Work not sporlflcolly doscrlbed or shown will not be., considered unless Praporty Stondords.
i . EXCAVATION:—
LoA
...._--------------
[tearing soil, type
SA riiO _
" 2, FOUIVDtE►TiOlw15: 'z.oac� Reinforcing.
Faohhgs: conCCEIC mix
SA-r- ; strength pet.__._
('� A/ C, Reinforcing
Foundation wall: material AAJCt--
L
=0 Party foundation wall
nter
Iior famdatlon wall: materit,l C..4 177 ' '✓
+V Piers: material and Fill
p� /gyp WU,
Columna, material end slitst -
r; ./ ial
Sills: mater
Sills ,
Girdet`s: material Acid sizes Window areaways .. �
oi Basement cntranc:e archway
Footing drains
GA, GAS`r�rt POc
r Tcrmte prgtccuon � � '-f" ,✓
on ,; foundation vents
C.74 1"Ct( insulat . ---
Bascmr: "s, ipacil ground cover _ �
i^1 Special foundations"
.. Acldtinnal .information;
s 4. CFIIN&MYS:
Material prefabricated (made and site) �I
1 - A-Ss Fireplace flue $hit
Flue "luting: material Heater slue "site
water heater
Vents (material and site f ; gas or ail heater __,+—_-- `
Adcfidanal nforrnaian:
4. FIREPLACES-: Ash dump and cleanout
Type; j solid fuel; [3 ga3rburning;` ❑ circulator (make and tete) heprth •5'A- ------ - i rnantel .
SI iJSG� 1 C Glt . ;lining/AG)A S---
r irenEace: luting r""'"....,'�.'..-�----�----
Ad�itiorat nfortnation; .
S: EXTEitiO OfY�ai LS',
species p�' '" c. _ corner bracing. Building paper or felt _!
Wood frame: wood grade, and spc i diagonal.
,tea tJ solidi ❑ spaced
_ " o,' r,.; ❑ Bg�,+ �//aCG�
SfiUC� Sheathing l.!/Z t -; thicknese.� t ;width 0�, .� ,size lr...�----; exposure 'r; faslenin
.bAll L i�ri--a rade .. *._ 1-_- -- + type
45iding i li: size i posure ,, fastening
cx �
Shingles ; grade , tYfx----------w i weight •.,
r, i.ath'� ,u1' SM
8_0UCrEd A thickntss l
Stucco — Baso iiashInti{
Sills t.rnteb
Masonry veneer facing material
"� facia thickness .._—..--,--- `
Masonry: ❑ solid ❑ faced ❑ stuccoed; total wall thickness .. _._..- -- g- bonding
Backup material +
thickness — .of ! S
Window sills furrin Baso `flashing
Wntcb .. •------
� 0000 lilt
K
►r surfaces: dampproofing, coats of '
�,
,veldltirsntl'k informis;tont -� (t jpp(p ;number of coats ,
r. EARAA � 5�'At rel - �t7'u�'r�l
k.xtrrlur >niritin � material - A
l g'
Crable wait- rgnsiruc tion same as resin walls; ❑other Construction
r ..
8. FLOO9 FRAMING. _ ether ; bridging ;archon
Tads, and apeciet ;thickness
r�>,t n ,
Joistx, wtuJj ground supported' ❑self auppar<ng; min ;
r
Crrucrctc slabs C) b srmgnt Haa i Mit. V / i7 t1 Cs is �+/
�Lnr /�i ;memo"rang
p / t�f insulation
rn xcinfgrclnFl "' i Additional in
�QG{x/1,y4ZG_; thlckncss
R ;k Kill under slab; 'material
R NP3,
�:. a„. !)estril:9 underl'lo rittg for spek1Q, floors under item 21.E r"'',
Additional infarmStiont
site + tyPC
t+ „! 7t+#r➢fsl` gratlts and sprcles �.,.t� q ri its an las.
attic .. _... _..� .., O Et„ diagonal; g li
"°t.aitl iflrit ti+lor, �j eertind hoar, L' ,
N "Fl rl. I o-. i, -J only. Describe other finish ltloorinE+ Under 21") � �_
._
,a ._ ,.r.� �• �ii1aTN Btrw, PArta• PiNu1t
y ~aa rtdlt� Cnr,ps .; Srac�rs TNt leas ��/% +� ; • � 41
,.+..M iin•r�d'F-e
�'.rF16t Hot' _ _./t`
q �
4 Second it •r »--�► t► ._._.., ,,'
Attic Hoar'
r„�,;;+►d,�,�ti,�1',. �.:;". f. �'' ,atian� a'" p���R9+�`P0° �C3+8t tiA�►TCR�'A��is
RA form :Zt i 1
emu wlwantinm
..._..,. {YAP.
rW\N. �.,�y .aI1Mh1n .,' Ai.•.�'. ter: try rlt.�p MY+..S�.�1.•.•".' . .r_ —.
rr AND WAIMC®i,
1. SPECIAL 'FLOORS /1 Tha"ILIr r;iKa WA44 BA>t UNDGRn"Doa
i LOcr1T10N bviA7tiatAi, Cows, BORD", sut", Mot, Fw, MATMA4 Ib:ATULAt !►IAftl{1�4 _
r !Gi V GA Lam. At rd rt Oc✓Odt� G� M`l c r4 C,t GJ l - 5
3sic � ►�f
CAA.,
w W SRLSI GAaa Enc. J liucttT Ovsa Tux (Fsou F�oa)
t{uanr biaarrr IN $Howells
� 1..acATlo;v » MATEatA4, U=9, i3oiwaa. ,
Bath-
Bathroom Accessories: ❑Recessed; material _.; number ❑Attached; raterial nutnbct ---
` Additional information:
12, KUMS1140i
FittTUAs NVMssR LexUTtoH (•$wax Mrp`s F1XruMR lrrst+rutawunN
l I I TG'Hl tM 7t , ' 7"� , cJ E'7 E'sL . l30 6, v 2 ��
Sink1t It ( V�tt"Y� I�kl;G A(/AG- WNtt'r
bA7t1 f -
t.xvatory t y w -,A r � CAS F r l�I,� rC�+. ,a v
�
W
wr•.(I
.^-.ter closet� �1�1-�C''3!
l
Bathtub / IJA7N'I- �. MC
10 zn�j
a Shower over tub /' "YLG L /� SS '¢ /— iv r
Stall showcr� / AT/d '»3 11(e�1. , S 2"o,
t _ j/�aE7l-Cr-C A S S, SIA1&L, 24-
^' Laundry trays ._ I UIiJDll- i
j /\r"1"t �t1 C5 *- N U /Lr2 S S' rl�O�iU �Al o rr J 2"
per_
Ml _r'
r �� A7t S'/AI C16 V CCNiiLO L 6Ld~!1.
_(mac -o Alc_
CML— p, -,j. rq tt� re,. /I
�1 !\XC'itl'IAiu n><l 4% Door [3r Shows pan: ma
�(,�'•c"'I"�CtC.�Q�.�
Wafer str;►ply; C]public:; ❑ co nlnunity system; kindlvidual (private) systrn►.,*
St wa a clicpoial; Q public; ❑ commun!ty system; individual (priyatt) syitem»*
» *Shaw and describe in4fvidrtal *stem in complus detail in se race drarwin�sand specficaliorrc according !o rtquinrmrnti, 645,,, /skyv
(inside). ❑ ❑ �( N✓ House sewer (outside)t cast iroSili cixks, n other
siva ized steel co r Lubin ❑ other
❑ ❑ }
1 W ❑ 6 Ppe- Bi umber --
t
House drain cast 'iron; tile; other
w
Water pe f"tng n) /L ?�L! L G` r cr
l � ; hcr!�ting cspacity
� •- make; and mrsdel --_ =
i t Domestic water heater: type __,_; capacityS+ilaa7s,
4, BPh, Ibt)' rise. Storage tank: nTater'lal__________. ---
Gas service ❑' ❑ other Cas plpmg: ❑ cooking; ❑house haAtir;g.
g ' fifty company; ❑ fiat pet. gas;
tit nested to: ❑ storm scwer; ❑ sanitary sewer; ❑ dry well. Sump pump; make and modai
r i"ootut dfatns con
capacity; discharges into
23.
I"'I Ibot water, ❑ Steam. ❑,\vapor. ❑ One -pipe system. [] Two•pipc systema
I}�t�, INGY.
[j Radiaton. ❑ Convertors. [J Baseboard radiation, Makeand model `—•'—'""" ""
llulturit ir�ttrr.E; U fltN►r; ❑ w+►11; ❑ crilinQ. E'artecoli; materiRl,_.�._..
[] Circulator, ❑ Return purnp. Make and model ; capacity 8�.
Boiler; make and model put Btuh.; net rating
Out
Additional information; � �,� �� •
Warm Air, ❑, Gravity. Forced. Type of systemr1P �.�r
�, , GG"�C' insulation F 1 N ❑ Outside air Inleke.
Duct material: supply G' r , return f'8tuh.
I Furnace: 'rnaka and model Cr'a/L/L t 04-' -V4 C+ Input Huh.; output
r floor furnace; wall heater. .i lituh.• number units
Additional information: ,
❑Space prate , ❑ ❑ _ Input
Btuh,; output r
' Make, model r Additional information:
". Controls; make and cypcs %?_MG GLOC/G �">'L.I'vt.O S �N r
Additional inforrnatlon:---------
II etelecuriother
g storage capacity �.-..-----------tet
b'ttrl, Q Coal: [3 olli [3 gas; C]4 gas c;
p»
$ Ad�litil►nal lilfirrniuttuns M:._..�......._.......r_.�..�.._..•_• �.,,�r.........,..�.._».,ru___....�.�.w...,.....,..�...��....-...----------�--•-�`*
i.; Firing ,equipment funilshcd separately: [3Gas burner, conversion type. ❑ Slalicr: hopper Pied [], bin Iced (3
I(� Oil burners ❑ p g; vaporizing
rcasure atomlzlni ❑
r Make and models Control .._
{ Additional. information.
l:leetrir heating systetnt tyle: ---
Input volt$; output
# s Additional infocmations .._........��-.� 2•b
cfr.T.
E \erntila"tin¢ paci
equipment': ailic fan, make and
mode — M!
{ ` kit+iyca .eschaust Pati, Maks acid rtteide! . r.� --' -----'_-',
Otlicr heating, ventilating. or cooling equipment
ilt� tJ .S'� N l -f
4 14.; t~I CTRlt WIRING: .;r ,' y , A l7
a IE,r, l undc Uttu» ? !^sit Rase pox, Z.1 N5Ca dot; AMP s .:........, (`ia, cin tilts »....�.
';ri++rrea uvedle d rg►x+ µ t cltcuit•brcaltet'
l ^ w'ititig ,,tin•
t �5 ttnt,la unrl iuG�, uttier
" e, lull. ar� veli cable„ ., nmt.tAlli+: t il it
SfrsYt t;ii rrutiets range' wafer heater other
-
Doorlxli. Chimes. Push-button los, tions
llnnlT L"1� /-? '�"`"T.cdiuonal iufortnaton:
a
2s; LIGHTiNG F•IxrURES: $ (,,t,
Total numtxir, of fixtures L�11y S typical installation, >i OVIDL 6y ouJti%t� ✓
f M Total allowance %r fixtures, t r
i Nanlyplral tnatallatton --
Additional information-*
A.
DESCRIPTION OF "TERIAfl.''
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