|
::n\'7'.,.[7':�
<br /> . d?`J,'�; ti
<br /> � , _ '' ' � ' DUILDIt7C PEfiMIT APPLICAiIOY - , �A. �,j� �:� �:�° '. �;:'i
<br /> . .
<br /> � , , , : Epplicant To Completc This =orm at 7" • ; ;
<br /> • ' I! more than one buildinq is to be contructed, submit a separate permft pp i a�y�,G
<br /> . . 41on for each buildinq. �1 separate permit will be issued far each building.
<br /> . � ' O+raer �lY1L j-�/i(7(> SF�NE'T- Bnilding Address �9ni ������*---% E'� '
<br /> .� • � � lddress �ts�/ �n � (� :i ii 1�r Lot� Block �
<br /> . / '
<br /> ' . Clty �L-�if-:� Phone ,Z:iu��S�F� Subdibision (Plat) : �
<br /> � dithitec./En in �/ -� � • � � � ' � , • ,
<br /> g eer,-f�, ; f=!17 i= _/�E '�^.�;
<br /> . �i . • =i �tY Xc'/�i?E1-� Phone „Zy�_ggy/ 7Setes L Bounds (Unplatted) ' •
<br /> - ;,•: Caatractor —� _-. f _ ec. R e , -
<br /> . •�, .� . � %C/�` �+p. g
<br /> �. ' �'. . �. lf.dress -,�. .`:�','y, . . .
<br /> � .��; City �et�,i/,phone� guilding Use ,�i/NE�.'% E��%•�yp3d�
<br /> •�j , ••`' � . .. • . . . _•r�
<br /> � � �'r� Siate.License Nc�abes L�e3cribe Work to Be.Done `�'� F�
<br /> � : . ,r. � . . . -
<br /> : : 'I E:piration Dat� ' • • � • � � � � •
<br /> I
<br /> '��' � . • SX%TCH PLOT PL.127 BELOSI' • � '
<br /> _ . f . • . e . . . .
<br /> : :� � . ; , _ ' . Dse of,Buildiri4 �-I t�.�pC la� t�l�Ge
<br /> i . .: :� : .. ' �/ _ .
<br /> �~ --�-r--.,'�-��-+�''V� ' . ' ZLlji�r7 G Addition ❑ Repair/Remocel
<br /> . . . �' • ,!`�, ;�
<br /> . � I . . . � '� •. �`.\.`-`„ FF�iIIAtion of Constzuction S ,��o�'�'. �- . . ,
<br /> "'�,; •.� I , - . . . . ., . � �=w � � \� � PIQT PLAN REQUIR&`lE:ITS . : � .
<br /> . , . , , . . '� �.`� � ' �� . � ' .
<br /> ' , ,, - ' b: .:.:'. 1 � jr, , v / . '•?
<br /> � ,� - � � �. . . ��'^- � �� � �� � �� SRdicate lot size, nane of streets�, '
<br /> - •�� � ''+ _.� . '.. ' ' �' ' • ^ o 'indicate location snd width o: � �
<br /> , � _
<br /> �,, � I _ , '•: ` � � � ��yb;+-J: •.�;��r��• alleys, locate proposed ar.d all �
<br /> • ,• f• - i�\ � _�' . � existing buildi;qs, show distances
<br /> .' � • � •��" _'_ '!' ``Ta " +�°� ; '� �`, " to property lines, show distances
<br /> 1
<br /> �. '^ ' — � `, • �'� -;-' ! � . between buildings. . .
<br /> - - ��--�-..�r �°y�A� ` ' ,
<br /> • . ; ���� �'/56 ?-: :' : ' 7Got size /.lyE x_ . � � jf � .
<br /> : . � . . . • a .
<br /> .•.. . . - . T.ot area _/�Jl���/-' Sq. Ft.
<br /> . . i'. r.. '. • .. ....... -.. - � �-_ ,•.,� . .. Size of Bldg. �� .t ? y� a. Ft. �
<br /> J �;. . • Nwnber of Stories ,�
<br /> . �; � . "� ' . • ' • � Sasement •
<br /> •a:. • � _ .. . ' , _ ' !. • . _ NPNF
<br /> _� i� ., . � , . , . . '��, ' Si9ned IIy . /�t.. = di��/r�� .c� � 5.Z�93Y7
<br /> 1
<br /> ' J I
<br /> . _ . , j . • ' • • ' •• o �For ��C��AI% �� c� »7/P•7'
<br /> • " . . � Owner Phone 95;r• Jzl�
<br /> ..' � DO \0: tCZ?TL' T�?LOF7 THIS LS:IE-cOR CZTY USE OiIL'1` � .
<br /> : - _ Date �ecci�•ed /1 _�/ '?`� � D�e• 7.onc ��I:Ji.uc,t�= �l.v�. �.Or.� •
<br /> ' Plan C:�eck :Iur.Ser 7'�`'�a� ' F.ir.e Zonc ��3 • '
<br /> � Yaluation 4 C� 'Sq '��--�� Qccunaacy Group "� �
<br /> PemiL• Fce d � ., Oc• t/ rX/ ' . ' .
<br /> ���' �7e � 2ypc o£ canstrucL•ion �l 1�1 .
<br /> ' Flan Chec1; Fee, �7S��U� ' �/' , Occupant Load • '�__ �
<br /> c�U . • •
<br /> . Total Pec Uue �'y -� Spzinl:lcrs Required ' '
<br /> I�atc zssucd • ' • ' .• • . ` CfYY•�OE'. EY[F;ETT
<br /> ' ' • , , , � . . , , ', {I?pROVE�.•�UR Bt11LDING PERMf•T .
<br /> • ' . . • - . • . • [�+te.. . I•t',l � �y I� . �_ .
<br />
|