|
� •• i • ' V�/aYVI�\V CLIY'111 i�YCL1l.��11VIV � • � ••� yX�
<br /> _ , + , , � �pplicant To Complete This =ornt / c� Q��/Q��; :Y .
<br /> r � � v ,
<br /> . ' • Si more than one buildinq is to be contructed, sub:nii a separate permit app11/�3��
<br /> .• : tlan for each buildin�. .1 separate permit will be issued for cach building.
<br /> /� /
<br /> � . � ' dmer /� r/S Euildinq nddzess � ���0 �j ��,k„ud�':
<br /> � ' � • . � Iddress D ' ,,/�� � �� L
<br /> , • �y�1{� Lot Slock ,�� ,
<br /> ' . . �h' � �r-� Prione / Sabdi4ision (Plat) ���NY L /Je � .
<br /> _ � � lschitect/Enqineer � � _ �L yf �r� :,`, �� Z � • ' .
<br /> _ 'i . . "='� �tY • Phonc ltetes�t ounds�IInpla�Eted) �' . .
<br /> :., . , j � �/ . .
<br /> � ':. :.'. Contractor f �ii �'! . � 1 . S,p. R e . -
<br /> _ �;, . r• Mdzess ��� d �/ �/✓� . . 9 ' ,
<br /> • .�� Citr /� /�..0/�.:F'� Phone 3��/�ilding Use /, //�S /' S' � O . . .� .
<br /> ,���;.;'•.
<br /> '�s � State 7.icense Ncr�ber r '-���,•' �
<br /> r . Cb���I>-�y/ Desc ibe Work to Be .Done
<br /> " . .� . .
<br /> ; . � 'I Ezpiration Dat��� 7 � •�l� • ' �/O o (�/�' ���'�� •. -
<br /> .. / �
<br /> L�' � . • SICETCH PLOT PL.1N 8£LOW' • • -
<br /> _ .,r:_� ' . • .. . . . � Os�e of Buildirig ' '
<br /> . .
<br /> �� i • . � . � , „_ • �New ❑ Addition C1 Repair/Remo�el
<br /> � �' �� � . � • • • �Valuation of Constzuct,ion $ � .� �U
<br /> .� .. . �
<br /> �,. � .. _ . :., . . . ... ' � • , , BLOT PLAN REQUZ_4E�fE:7TS . '
<br /> � • ' ' � � ' • • ••� .
<br /> .' � ,' � _ ' . ' � ' • ' ' 2ildicate lot size, nane of streets,
<br /> ' ' .� � ; , � y:: ' , . . . '• = i, " •indicate location and width of � :
<br /> allcys, locate pr000sed ar.d all �
<br /> ' � i�� . • - _ � r ' " : . '��i • existing bnildi:qs, sho:v distances
<br /> - , s _ . ,. . •. . . to property lines, show dis:ances
<br /> t.� '�'�, . _ betveen buildings. .
<br /> �. ' :• '• '. .'. .. . . . . - ' : bot size x ' .
<br /> • ';.i- ! • . . � • - ' Lot area �
<br /> . ' -: . . Sq. Ft.
<br /> . �`. r.. • • .. ,:.. • ' Sizc of Blcq. Sa. Ft.
<br /> � ` • ' ' Number of tories
<br /> ' :: . � - . , ' , . .. . . 8aseme 't i
<br />' • r---- . , . . - • . i -
<br /> :�
<br /> � 's' • ' • . '. , Signed 8 _, '
<br /> . ;� . . . . ' - � f -
<br /> I _ . • . ' . �.' For • .
<br /> • . . . Ownez Phone
<br />� • : . . ' . � . . � . . j/ ' ' . . ' .
<br /> �• DO :10: Tt:iIT£ IIELOM THIS LI:7z-POR CITY U z Oi7L'1 � - �
<br /> . _ • Dacc Seeeived l � � f "" ' � •
<br /> , _ _ 7 IIsc• 7.one
<br /> " Flan Chec;; :7ur.Ser ' " ' Pire 2one ' '
<br /> • Valuation 3 S C� ��'' Occuoancy GrocQ � _
<br /> • Pcmit Fce � �J• �-' • �rpe of Constzuction •
<br /> Plan Check Fee "'�--r �
<br /> Oczupant Load
<br /> . Tolal Fce Duc � r �� � � • '
<br /> Sprinklers Required
<br /> Date Issucd � •� C� y' � '• • . • . , .
<br /> . •. . . . ' ',c.. . • . . .
<br /> . ... • . � • . .. '�: ''• . ' , ' • • .
<br /> , . : , , :' • , • . , � ,
<br /> , • . . . • , , _�r
<br />
|