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<br /> _ , �� . — .. . • IIOILD2IiC PERMIT TI'PLICATI017 . ,'F�,✓/,•/•; ' .;:.�
<br /> - ' �' � ' , , � Rpplic�nL To Complelc ?his C'orm . . . ,y
<br /> • • ' IE nore than one Uui7.ding is to Uc contructed, snbmit a �eparate pemit- applica-• ,
<br /> . . S:ien for eaeh 6uildirg. �1 separatc permit will be ic:ved fur each bui].ding. .
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<br /> . � ' 6ner 1�i4L Ti2 /�� �� `, i< Duilding Addre�s S�%:'J � ' ;
<br /> � • � . . . � w�r,1 � �� ' <.. , .
<br /> . • _ ISdares:, S'L. G j`,�,! „ �-r �, Lot � Yilock '
<br /> ' City f'o:�?Y f7` Plione � s� ' y'�� y .^.ulxiivision iPlat) � .
<br /> ' • Etchil•cct/Enqiriecr : }-.Lr- � . .
<br /> • : "'� City Phone I�Setes L L'ounds (UnplaLted)
<br /> - - , "1 .
<br /> . � . ;, Cantractor ^ec. 2�.+p. Rge �
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<br /> _ . � lddres.. ' -
<br /> � .City 2hone Duilding Osc `�i 5�c�z , �. �' . . : �
<br /> .�; . , * y.n :�
<br /> �'�:; � Stete.License 27t:.:J�er Describe S7orS; to i3e Done ��: /- �'�` �
<br /> : . . �i �iration Dat� � ��.,,/ /� ' , f i`== .
<br /> . ��' � , : ST.I:i'Cli PL'OT PL;II ?3ELOf4' •. . , � "
<br /> _ ..� ' — .. � � c �� . �.
<br /> : : j '. . - . ' �Dse of. Buildir.g _ � ( ` } ' '
<br /> �' � ' � � � � � � � �Pe:r ❑ hddition 8`Rcpair/Remo::el �
<br /> - . . � �� �j��',� - . � : � � .
<br /> . ' � • • . . • Faluation of Construction $ LD6'�
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<br /> �' '� � . . � . . ^ 'PIAT PLti2d REQUIZL';::TS .
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<br /> . , ' � ' ' . ' � ' � ' ' - 2ndicaL•e lot sizc, nar..e af strect^.,
<br /> .� ! � , . . - , • � •indicate location ar.d c:i.cth o�
<br /> _ � ti • • � . • all.cys, 'locate aropo�cn ar.d all .
<br /> . j ?� - ..-. - . . ; . . . . � .
<br /> er.icting huildings shc:v disiances
<br /> - 'a •'- to property lines, •�how distances
<br /> , � ' ' q • � _ bet-wecn L•uildinqs.
<br /> � . _ . . . ,
<br /> , , s : •• . � : : � Z.ot size x
<br /> ' . -- � ' • i.ot area Sq. PL-.
<br /> • ,;. = � • Sizc of 1'ildg. So. Ft.
<br /> ` j , • • 1Avnbcr of :;torir_s
<br /> • •; • 1. � . ' � Dase:aent �
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<br /> . �..-- • . . . .
<br /> + :; . . Signc By
<br /> i . • . �� . ��`�
<br /> . _ , . . • For S;- �2t 11�5_2' /�,k�Z� . �
<br /> � • � . , . � • �incr Phonc �
<br /> ' : . � . . DO :70: Si:Z?TL 9?T.0'.7 T1SS5 7.I:drrFOR C:7'Y US?i OIIL'I " � . I
<br /> , Datc reccived U�e Zone
<br /> ' Plan C1ee,: `:cnScr ' ' Firc Zo�c ' �
<br /> \�alua:ion _ Occunnncy Grou�
<br /> Pc:Dit: I'cc Ty�ic of Construction
<br /> Plan Cl�ec): Pcc � Occupant• Load +• �
<br /> . . , 51;ta1 T'cc Duc � ;prinl:lcr� R�.quired _ '
<br /> D:tc 7�::ucd _ ' • • : � _
<br /> . . . ' _ . ... ' . �ni'� ' � n I�
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