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... ; -_ <br />� 1 � � BOILDING PEAMIT APPLICATION . � ' <br />-- , • ilpplicant :o Complete This _'orm � � d� 3'��, <br />- . . . . ,� i,,!. i; = <br />�' It m��re than one building is to l�e contzueted, su6mit a separate permit applica- <br />., tion for each buildin�. �l sepa_ate permit will be issued for each building. <br />"' Ovner I � ��,�.a Suilding Address �9�.}� ���.,��.�/ <br />. iddress � y 2 / ,?�.r�N� �t slock �� <br />fity J nf � YAone j_.ti S-r4s� Subdivision (Piat) ' <br />' - Architect/Enqineer � _, <br />'"� City Phone Metes i Sounds (Unplatted) <br />_ �� <br />� Contxactor ' Sec. 4wp. Rge <br />. :� . <br />' , .. address � <br />- . - ' • � <br />� City Phone Buildinc, Use _ <br />'. ;� State License Nu.�her Describe Wozk tc He Done . " <br />L <br />. 1 . <br />� . �. "i Tspiraticn DatE � (�, • � <br />. � - <br />��� � . SRETCH PLOT P:.AN BELOW� ' � ` �� N . <br />• �� � IIse of Building <br />• . �,� . ... <br />i. ' -, , ❑New ❑ Addition � Repair/Remo:tel <br />' • :� Valuation of Construction 5/ o-T"'� <br />� . . <br />• . � � � . ' � - PLOT PLAN REQUIREb1E:ITS . <br />�' �. � � � ���� • . <br />' •; , Iy • • indicate lot size, nane of streets, <br />� �; .n O • ' indieate lecation and width of ' <br />j I. - �� . alleys, locate oroposed a.-.d all <br />' � existing buildings, sho•.+ distances <br />� .i . . ._ y : , .�.'. �j to property lines, show distances <br />' • ' ; . ' � - betWeen buildings. <br />�� . • . � <br />_ .. ' Lot size x <br />' a Lot area Sq. Ft. <br />��� . . • � Size of Fildg. Sq. Ft. <br />.;.:. <br />, . Number of Stories <br />- i' ' , Basement <br />:.. - - q �.�.-.._ <br />: � ._ � Signed By ?N.t�o • � <br />_ � ✓� � <br />' For I r <br />. . ���__ // , . , / Owner Phone —.s� S � <br />R._�.u_.c..� y <br />' DOaOT t<ZIT� BELOH THIS LI:dE-P07 CITY IlSc Oi7L'I <br />Da[e Teceived Uce Zone <br />' Plan C:uck `]ur.,Ser _ ' Fire Zone � <br />Valuation Occunancy Grou� <br />F�it Pee � Type of Construction <br />Plan Check Fee � Occupant Load <br />, Total Fee Uue Sprinklers Requfred <br />Date Issued . • • • ' <br />• . , <br />