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• - - . � - - __ . -�.._.�. . {._«
<br /> _ • . { . � " ' � ' DOILDI27C F'EFiHIT APPLLCATION . �/� •('Y, • ! � '�•'
<br /> _ M �� +. � � � Appllcant To Complete Thi:. :orm . /��/ 0 %�i/,y�;,�
<br /> , • • ' I! porc than one buildinq Ss to be eontructed, submit a separatc permit applica- •
<br /> . , tlon for c�ch buildin�. �1 separ�te permit will bc issucd for cacti bullcling.
<br /> �o2f �: ��Uc , ._ � ' .
<br /> . � ' Ovnet Huild3nq Addzess ( .
<br /> � . � . � liddress '3 �/ ,.�� 2t'-G'-�� Lot -� � � ` � � � Hlock - '�,.' -�> i� -.
<br /> ' . CSty � Phonc .,�5� �7�7v-3 Subdi��ision IPlat) , -�T ii,,�, -�•� �i' • .
<br /> ' AreIIitect/Engineer ` ' � � ' �: - '- � _- '
<br /> _ `ti : . .`.'j City • Phone Hetes i Dounds (Unplatted) •
<br /> :., . . j � �. � � . , '
<br /> ;,• Coatzactor ' ' _ Sec. Swp. Rge
<br /> , . . .
<br /> a �... � lddress . ,
<br /> _ . �
<br /> '1 City P6one enildinq Use _ ' '•: =:�'
<br /> .:4! . •_ '. � . , . . . •� "".
<br /> . 7 '. �.:.F..Y.
<br /> •�.� • '�;i 6tate.License tJuaber Descrihe Work tu De Done � .
<br /> �
<br /> • : '� Ezpiration Dat� ' ' '
<br /> �.� ' � • • SICETC}f PLOT PL.l'7 BELOSP' • • .
<br /> _ .�� . . . • . � ' } ' i
<br /> '•J.. • .. Ose of Buildinq �� -1. , —f�, i
<br /> � . .
<br /> �• j ' . " " ' � , ,,, • �Hew ❑ 1lddition ❑ Repair/Remo�el
<br /> . '. .,• . , �
<br /> � � '' � • ' Valuation of Construction $ /.�, !�c:C' �
<br /> ,�,�� � �i- _ ..� ,.. .� . . �, � . ... I . PIAT PIJ1t�7 REQUI?tE`SENTS . , ' .
<br /> IJ 7
<br /> � , . . . � . . • � � '.?
<br /> {� • • , • � Zndicate lot size, nane of streets,
<br /> ' i ' � ' + ' - •indicate location and aidth of _
<br /> . � ;� I � • " i:: - ',. j'� • alleys, locate pr000sed aad all
<br /> ��.� � . . . • " " . ' ti ipzopertylliness�show�+distancess
<br /> ' • ,,'.M ,"� . ,"y,
<br /> � '. 1 t . � � ' ' • , betaeen buildings. �
<br /> . . L � � �• . . • _. . • . . . .
<br /> , . � �' . . , Lot size ti�" x
<br /> � � �� Sd- . • • • ' ' • . I.ot area Sq- £t-
<br /> ' � �7 , , � � � ' � . Sizc of 81 g. ��.�r ..c Sa. Ft.
<br /> ' .� r' • . Number of Stories i
<br /> :. i • , • 8asement
<br /> �r..� . , ' � �� � , ' `
<br /> ��•�. � Signed ey �.. .�..rt. ` i ,. ��
<br /> '_ � • , . . • For
<br /> • . ' • Owncr Phone ? �,� - '� ' ' _
<br /> .,' � DO :IOT li:tIT� A�LO:! THIS LI7£-FOR CITY L•5E OIIL'! � �
<br /> Dnte A�eeived U C IIce 2one •
<br /> ' Flan CSec;: :7ur.ber ' ' P_te 2one '
<br /> Valna:ion � `�i �� ��� Occuoancy Croo,
<br /> . . . , • �_ c ,
<br /> Pemit Fce l` i • 'lype of Construction _
<br /> P1an Check Fc� � Occupunt Load _
<br /> , � ibtal Fce Due / � • < < SprinY.lcr� Reguired � •
<br /> . ' Datc Issucd c. �- - 1 __ . _ . . . ' ' . .
<br /> . , •� ,
<br /> � • . , .
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