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_. � � EOILDING PERMIT APPLICAT:ON 2 <br /> ' Applicant To Complete This ^orm J�� ��r/ <br /> f <br /> If swre than one buildinq ia to be contructed, submit a separate permit applica�� JS <br /> tion for each building. A separatr. permit will be issued for each building. <br /> l � � u <br /> � �1fAlI [ � /i r('.�i �'� � _ � . ' _ <br /> Buildinq Addres9 � . ` r, ; � <br /> . Addresa �'-��� �: / ��c .. , �� � ( .� � Lot " ' �{ �._ : - � <br /> �� Block � -c � � ) c'i <br /> City � � ;��l �� f r Phone �5 1 ��. `��-�'� gubdivision (Plat) <br /> Architect/Enqineer �— ' , . ' ' <br /> -_� _ : � �.., � �, ) ti . <br /> I ' <br /> _ :i City Phone lSeies i Bounda (Unplatted) , <br /> , Contractor .��C�L� Sec. <br /> __ 'R+p• Rqe <br /> _ Jlddress <br /> Ciiy Phone Buildinq Use ' <br /> . �. <br /> . ,; State license Number Deacribe Work to Be Done �� <br /> � i Ltpiration Date <br /> _ ��: SRETCH PLOT PLAN BELOW� • - <br /> ; • . <br /> � Use oE Buildinq ' <br /> -� � �>'�.7�<<< �' � �. �� c; ��F ,,, _ QNaw' � Addition ORepair/Remouel <br /> -1 - c'.c- <br /> ' j��;�;�Z Valuatio� of Construction ; 71 S -- <br /> • - <br /> "�� � . ' PIQT PLAN REQUZREMENTS <br /> : /,� / �1 . <br /> ; /� E/' C «� t �'rj5`�' %���,� • Iadicate lot size, name of streets, � <br /> j � indicate loca[ion and width of <br /> ;.� ���.� S� 1� � __. ; C', ; � � alleys, locate proposed ar�d all _ <br /> � j ' 7 � ,�, � r�� ' existing buildir,gs, sho�odistances <br /> � • - • - to property lines, show distances <br /> ; • , • between buildinqs. <br /> . Lot aize x <br /> '� Lot area Sq. Ft. <br /> ,', •�• ' ' Size of 8 g. Sq. Ft. <br /> Number of Stoaes <br /> :.. <br /> • � Basement <br /> � y Siqned By �; _ ,l �%1�;��,^� <br /> � For <br /> . Ownez Phone �, 7 - � � <br /> DO �10': {ti;iITL' 9=LOI7 THI� LI:7E-i0R CITY USE ORL'f <br /> Da[e �eceived � �� Uce Zone <br /> Plan C:�eck :Jur.,ber ��—� Fite Zone � <br /> Valuation � ) �, �'��' � <br /> Occuoancy Grou� <br /> Pemit Fee � L� �� _ �rpe of Construction <br /> Plan Check Fee --- _ Occupant Load <br /> Total Fee Due �. ��� C_� _ Sprinklers Required <br /> Date Issued �-- � �]�f ' ' <br />