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� <br />e <br />.. <br />� BUILDING PERh1IT AnpLICATION i �/ % � � , . � <br />Applicant To Complete This ^orm � 0 lG � <br />If more than one building is to be contructed, submit a se ar�te �/J�a/7/ <br />p permit applica- <br />tion fo� each buildi�y. A separate permit will be issued for each building. <br />�e! � �- _ Buildinq �.ddress G5Z5 /l�Ur2�ti �1..�.'�i. <br />Address ��UL(Z Lot 1� Block �- U� <br />City L//LRL 1 � Phone 35 3 Cy Z7 Subdivision (Plat) <br />Architect/Engineer rjo(�j�-} r�V�R�.y nAR{C <br />City Phone Metes s Bounds �Unplatted) <br />Contractor � y�-� ��,,,�;7- iri <br />i <br />Address (� S G_S" /�r-i!1= R �� %� (,.✓c� <br />CitY L- 1% F R f. T ii Phone 3 5j � 4 Z'7 <br />State License Number /O 0 % � <br />Expiration Date /� � u� �% 5 <br />SKETCH PLOT PLAN BE:,OW <br />I u,. RLLGYfi • <br />\\ <br />�� ",, P°�'�- I �n <br />`•l�i 3 I I S ('�1 <br />� I__I N <br />I I <br />__ '-i0U5t � <br />�_ r--- <br />�-- �o' —� <br />�LU�.RIY hl-�c� <br />DO NOT [•:ZITG 6EL0�9 <br />Oatc .xci+;,,+ I(7 G'/ 7� <br />P1an Chec:�: `:c�bcr 7�-"IY � <br />Valuation 'i� g � Ot%� <br />Pemit Fee �� �[) <br />Plan Checl: Fcc {-�}�d -���j '� <br />� �� <br />Total :'ec 7uc _ <br />Date Issuc-1 <br />Sec. 2Wp. Rge <br />Building Usc �/} R/.� (' 4 �� <br />T <br />Describe Work to Be Done � <br />G�rvsTr.u�l Nrw ('aa/�c�� <br />C�,;NI.(LLf � SL/aU C��nnC� �/?/�MIAI <br />Use of Building �',r.�nR � l= ' <br />�New ❑ Addition ❑ Repair/Remodel <br />Valuation of ionct_uc�:on S �,OO� <br />PLOT PLAN �LEQUIREh��NTS <br />Indicate lot size, name of streets, <br />indicate location a:�d width of <br />alleys, locate pr000sed and all <br />existing 6uildings,.show distances <br />to property lines, show distances <br />betwecn buildings. <br />Lot size _� U x '� � � <br />Lot area G.'i� Sq. Ft. <br />Size of Bld3• Sq. Ft. <br />Number of Sto�ies �j��� <br />Basc�er.t G <br />Signed £y <br />ror ��-f/p�;,p��i <br />Owncr Pnone �� <br />'F-POR CITY USE O.ILY <br />U�e .".one �S <br />Fire �onc <br />Occuoancy Group <br />Type of Construction V— t..� - <br />Occupant Load �� <br />Sorinklers Reauired j�'d <br />CiTY OP CV�nE-' T _ <br />APPROVED i G�'• I:, �„ `�;,:, ''��'.11T <br />�, , l r../2c f 19' �' �"`— <br />R <br />