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• � nozLoiNc rrnr�i�r nrrLicnrro�a � ��!� y I �• <br />• Applic��nt 'Po CompJ.etc �r.�,xs r•or.m 3�%��G <br />if more than one bui.ldi.nh i��t•o be con�tructcd, �vUmit a scpar.nCe per.mi.t <br />appli�•at•ion for cach Uuilding. A �eparat•c per.miL wi.11 bc issuccl for ench <br />building. � � , <br />Owner %i":��.f',�/� �� ��� IIu•ilding Address ��3v- �,.�w� r-�.�, <br />' 131oc): � <br />Addres:. 3 - i �.� • Lot f� _�_ <br />/' <br />City Y_,.c�o__� nha e 3 S3•-� �� � SuUdiyision (Plat) '�' 7� <br />Architect/Cngincer / . �.9Vr _ /� ^��, .��� Z��`• ' �� - <br />Cit-y ,�`�� Phone �� �% ,�/ .d[. Metes & F�ound� (Unp]atted) <br />< <�t�'L�t Sec. T���p. l:qc. <br />CoritracL-or /�--, � ��•��./� / ., <br />hddre-ss � .%. J_i J� � <br />City �.�n :u, Phnne (r%�"�� �� • . <br />Statc License 23umber �z 3- o/- Sf c� • . <br />Er.pira�ion Date <br />C01•Py PLOT PLA17 Oid REVERSE SIITi <br />iCiOTE; <br />C <br />. ,8�x►.� laQas i,u �,�r �.�-/, 5��.�,i.c. .. <br />�'��A'!L;' G9[1l �f�J5<,w. �E�✓vE.�.�CE . <br />ZQtl� ,� �.ol� Tb t3E Ur/GlbL-t� <br />' �.8 _ �E7zSGk/al. u5� � �.1oT ID <br />,$Ec,a�,v� d .guS�.vG�s �/a <br />Go.�rtir�ix .5��z�a� <br />• , � � '��L%7 S` . <br />'. • nn t.ot i�]ritc 3clo�•r This <br />Date Feceived 3 2. � � <br />ISlan Chec1: Number Z�o—l� � ' <br />Valuztion �?/�- O/ � ' <br />Permit Fee 2 8• �" <br />Plan Check Fee j l�. �� <br />Total Pee Due . ¢2• °O <br />Datc Issued � <br />IIuildinq Use <br />Describe S7or1: to Be Done <br />Number oi- Stories T�_�� -*-�., -- <br />Base ent ��7 V <br />New I�ddition Rep��.r./I:cmodel <br />Va.uation of ConstrucLion $ 3Z��'�� <br />Signed By , n � - , <br />For <br />Otaner � Phone <br />� <br />�ine-For City Usc Only <br />Use Sone � /� ��/� �W <br />I'irc 2one #3 <br />Occunancy•Group 1 ' <br />Type of Con�trucL-ion �� - �-t <br />Occupant• Lo�1d — <br />Sprinlclers Rec�uired __________ <br />CITY.(•lF E�'ER[TT <br />APPROVEQ FO� EUfLDiNG' PERMIT <br />Date :�%i .T �'�. _gy�;!._,. <br />