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BDILDING PERMIT APPLICATION`— <br />APplicant To Complete This :orm ���: �"� <br />If r:orc than one building is to be contructed, submit a separate permitmi f <br />Lion far each bull it A separate permit will be issued For each building is <br />Owner <br />r i Building Address (�j� r, J <br />Address' <br />('I Lot Block <br />city(' Phone��� <br />,-- Subdivision (Plat) N gn Qy�f� `�'2• <br />Archite g <br />/En ineer <br />•6 ' Phone <br />'' ,�� city Metes t Dau$d5 (Unplatted) <br />Contractor <br />QPA Sec. 2pP• e <br />.. �• Addreas <br />city�s i2`* Phon Building Use <br />State, License Number ��-{ ��—� yeacribe Work to Be Done <br />:I Expiration Date <br />SKETCH PLOT PLAN BELOW a/' <br />We of Building + <br />+ •.� . , .... ❑New ❑ Add.tiLit Re ai <br />on P r/RemoCel <br />• <br />Valuation of Construction s Jl (ar�n_00 s <br />PLOT PLAN REQUI:' TENTS . r. <br />Indicate lot size, name of streets, , <br />-indicate location an3 width of <br />alleys, locate proposed and all <br />l , .,,..•., �� existing buildings, shoe distances <br />to property lines, show distances <br />! . between buildings. <br />.A'! Lot size x ' <br />Lot area Sq. Ft. <br />Size of B g. Sq. Ft. <br />Humber of Stories <br />r. 1 Basement <br />j• ¢igned�Ay �- ' <br />For <br />owner Phone 1 = 1 <br />DO NOT WUTE DELOU THIS LINE-FC.R CITY USE ONLY' <br />Date received pre. Zone <br />Plan Chec3 ,aurbe—r �7TS�''4.3(p Fire Zone <br />f� ? <br />Yaluation Occupancy Group _ i <br />Pewit Fee r't�o- � Type of Construction <br />=D-4 <br />Plan Check Fce z3 $• Occupant Load <br />Total Fee Due G4 ,� Sprinklers Required <br />Date Issued . ' CITY O <br />• APPOVED'FOR .BUIUING PERMIT <br />K s <br />.. .. • Daie_ll..�tf "raTgy C ' <br />