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__ � � � EOILDING PERMIT APPLICATION ° � = <br /> . • Applicant To Complete This ?orm /�� �� <br /> 2f more than one buildinq is to be contructed, submit a separate permit applica-/��/ <br /> tion for each buildinq. A separate pezx�it will be issued for each buildinq[. �/)S <br /> �eL �n_SS S LpY„p �� Buildinq Address � ���f �,o--eoCr��t� <br /> , llddress _���y�� � � � �� <br /> �� �� Lotlo � Block ��j�J <br /> City Si�uc(.GT� Phone ��� 30D� Subdivision (Plat) '�'i14-o�2t- l7(J. � � <br /> 1lrchitect/Enqineer � <br /> J Cit i <br /> _ =i Y Phone [ictes c Boun3u (Unplatted) <br /> , Contractor � �j,r,�,r- � Sec. RYp. Rqe , <br /> _ Jlddress ��,-[� ��.�.�� . <br /> City �_ phone eZ�9 �OS Buildinq Use �f p� r-� e ' <br /> � � �' {.�. . <br /> � � � ,; State License Nu.�ber .�2�, 'b2 - /0�7 pescribe Work to Be Done �� <br /> , . . . . i trzpiration Dat� A - � - J�L � ���m q , __n ��1- ' <br /> uUv � <br /> . ��: � , � SICETCH YLOT PLAN BELOTQ' • - <br /> , ' 1 . • . <br /> : .� ���Q��AW�4 . Ose of Building ' <br /> � • . ❑Nea �Addition ❑ Repair/Remoc;el <br /> • � �, . � •valuation of Ccnstruction $�.?�!'r� nn <br /> ._...��z�— <br /> "'.- e � . � - , ' ^ . . PIAT PLAN REQUZRENIENTS <br /> � <br /> ' • � . �� '�.aS?IA.� . . ' � ' <br /> IndicaY.e lot size, nane of streets, <br /> � `�'TuU�Zu ' ' ' indicate location and width of <br /> :..� ' alleys, locate proposed and all , <br /> existing buildings, shew distances <br /> � , .= to prope�ty lines, show distances <br /> ; ' between buildings. <br /> . �: ;' ��2� Lot size x <br /> � � Lot area <br /> Sq. Ft. <br /> .." :.. • �7 � • , Size of Bldg. Sq. Ft. <br /> � ' . Number of SEories <br /> :.. <br /> '• t • Basement <br /> ` - Signed By ����� p� <br /> , ; <br /> � ; Pcr pu,�,c,ti 5C/ �97,� <br /> , Owner Phone <br /> _ DO :10: S4:IITL BE:,OW THIS LI:IE-FOR CITY USE OtJL'l <br /> Date received 4-- Z 3 A�e Zone <br /> Plan Check `7ur�ber 7S'� U'C� Fire Zone - <br /> Valuation �� �� Occuoancy Grou� <br /> Perait Fee Z¢. U U • <br /> Type of Constrnction <br /> Plan Check Fee f"Z . (� U Occupant Load <br /> Total Fee Due �(�,• [�b Sprinklers Required <br /> Date Issued �{-J�_y� /Z',� ' ' . <br /> � �`r <br />