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. �. _� <br /> BUILDING PERMIT APPLICATION � �.I�� 7 • � <br /> Applicant To Complete This ?orm � � <br /> If more than one buildinq is to be contructed, submit a separate ermit a 1�a�� l � <br /> P PP � <br /> tion for each buildinq. n separate permit will be issued for each building. � <br /> �QL ���ik�� dl�ll(`� Building Address <br /> ( c <br /> Address �� r���r{�p I t . » I.ot�_ Block [�n �- 00 <br /> City �{ '�_ phone - �Y�� Subdivision (Plat) ��� .��Q�t 1� L�(qy;;j 0.�, <br /> Architect/Engineer � <br /> City � Phone � Metes 6 Bounds (Unplatted) <br /> Contractor �J,yQ,R Y�1 �� . oYl�cC:. Sec. 7tap, gQe ' <br /> Address �� �U(fZ��QM Ll� � � ' <br /> Y �S�+s�i�—-_�S c�d.�LL�L 4 ? <br /> Cit Phone IIuildin Use � <br /> State License Number ���-Q�-�/�,f�' Describe SPork to He Done ��}�"�1} i (�:l ' <br /> E�:piration Da`e �,�(�--�j$� `, p��.Q � l� <br /> SKETCH PLOT PL11N BELOf9 ' <br /> � tlse of Building L,�Q���� ' <br /> ' ❑New ❑ Addition epair/xemodel <br /> , ' Valuation of Construction $��,°� <br /> . � � , ' • PIAT PLAN REQUIREESENTS <br /> ' Indicate lot s9ze, name of streets, <br /> _ - , � ' � indicate location and width of <br /> � , . � � , � alleys, locate proposed and all <br /> � � � existing buildings„show distances <br /> e '} • to property lines, show distances <br /> . between buildings. <br /> � , . Lot size x <br /> - Lot area Sq. Ft. � <br /> '.:. • � Size of Bldq. Sq. Ft. ; <br /> _ ,. � � Number of Sto�ies j <br /> . Basement <br /> � <br /> ' Signed By � <br /> For � <br /> Owner Phone <br /> i <br /> DO NOT WRIT6 IIELOIJ THIS LINE-POR CITY USE Oi7LY I <br /> Da:e :^.acei�r_3 Ute Zone i <br /> Plan Check Vurber � Fire 2onu ' I <br /> Valuation � ��R(� . � Occuoancy Group � , <br /> Pemit Fee Type of Construction � � <br /> Plan Checl: Fee Occupant Load i <br /> Total Fee Due Sprinklers Required � <br /> Datc Issued CITY OF �':''�'�'�?'I <br /> APPROVED FO� s;,���_�;:,,c;: r".::iir <br /> Date — DY- � -- - � <br />