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- -- - <br />--- .._. <br />. ._ - -- <br />- - --- - --- -._ .._,. <br />BUILDING PER6fIT APPLICATION �,y /.%� ' -: <br />Applicant To Complete This ^orm / � <br />If more than one buildin9 is to bu contructed, submit a separate permit appli���� <br />tion for each building. A separate permit will be issued for each building, <br />Ocmer �•�`j) ��;i%.1/' - <br />� I Building nddress / `�_' �i i;,' � (_ ����/ / ; � l �� <br />Address _ i`' ," '1 �>� L �` �i L�/ /Sl C i� r.ot 7/!' !`' , 3 Block <br />City l (!; /i'C� %� P:�one ,3,5 �-1 ,'�5 3 Subdivision (Plat) /y�( [�/� � 1/� ������� <br />Architect/Enqineer ' � , � <br />i.; ,� /1171-� <br />City Phone Metes S Bounds (Unplatted) <br />Contractor Sec. <br />Address <br />City <br />State License Number <br />Expiration Date <br />Phone <br />SKETCH PLOT PLAN BELOiO <br />�^'P• Rge <br />Building Use �$_ [� <br />Descrihe Work to Be Done ,��f: i1�CG't� <br />_%-'F/ / 7��/� -V <br />7 <br />e <br />nse of Building ��r_' S ii�i= �, r �,� L_ • <br />C]New ❑ Addition [7�Repair/Remodel <br />Valuation of Construction $ /C'('�— <br />�_ � • <br />� ---� - . l���V <br />/ ��/ <br />'� /'� �, l.'1. <br />� • h <br />'- - <br />, �`� 1z�P� <br />� _ � a.n,.�,� W� <br />. 3- �x$ .�IaF <br />PLOT PIJ1P1 REQUIRFI-0ENTS <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate oroposed and all <br />existing buildings,.show distances <br />to property lines, show �3istances <br />hetween buildings. <br />Lot size X <br />Lot area _ Sq. Ft. <br />Size of Bldg. Sq. Ft. <br />Number of StoFies <br />Basement <br />Signed By .��..' `,/� � ./ j--. �.r-- <br />ror <br />Owner Phone <br />DC NOT [9;2ITI' ��L0I9 TliIS LI;7F.-FOR CITY USE O[ILY <br />Datc ^.�_.._.rd //-/�- ?�_ U�c �one <br />P'an Chec'r. ^;uebcr <br />Valuation _�� �%' <br />Pemit Fee _��� <br />Plan Checi: Pee —� <br />Total Fec Duc <br />Da[c Issucd <br />Fire ZoRe <br />Occuoancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />� ' I ' <br />�,���i-w- <br />� ,-;. i !. I I <br />_ . . ' , � �;.',II I <br />d'— <br />0 <br />i <br />