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. HUILDING PERMIT APPLICATION ' <br /> . � -� AppHcant To Complete Thie Form � p�y(� <br /> . � ' .. ' � /U '� . <br /> . I�moee lhan one building te to be eonntrueked, eubmit a separate permit ����7.% <br /> ' �pplication [or eacb building. A eeparate permit aill be iesued for each <br /> bullding. ��L,� . <br /> Own�r�,_ � �� ���' J 1 � Buliding Addreu ?-"�• ' � �� �� i ' <br /> Addreu 3 3L _ Lot . ��Bloek � � ' <br /> C!!7 /vr�r%/ Phone Svbdivision (Platl���,�.,_� ;,;, ' _ �,: � • <br /> / <br /> Are�itect/Engineer � � � � � <br /> Cltp Phone Mete� & Bounds (Unplatted) . � <br /> Coutraclor� ��:�` �>,. � ,; �^ See. Tavp.�Range_ <br /> Addreu '� )� i . <br /> Cilp���[ tY.•i Phone �,.7 f�3t ' Snliding U�e /}�� �.� ��, <br /> Bbta,ISeense Number.���}-O/'�a(':'7 Da�eribe Work to be Done /�i . - � /t����,:'� <br /> E:plraHoa Date ����.��; : �, �� !., > � , C c�� c �� 'r / /,•; ' „ . <br /> SKETCFt PLOT PLAN BLLOW I ��� ��!�; 'l�i", ,, ,,,,7 <br /> ;i���.; �L �,� „ <br /> � . . _ � � 'V�a'o[Building <br /> _ ._.__ __ . _ � .. . _. _ . <br /> � _._ ��_�'__� ` . �� � . -- - - ' . .Cl New C[Addidoo - epair/Remodel <br /> � I5' . � � , �� � � Valuallon of Conetruetion E �:�U�% ' � � <br /> r . � <br /> S PLOT PLAN REQUIREMENTS <br /> � <br /> � � r Indie�te lot eize, neme ot etreete, <br /> �" ' � , � � lndicate location and width ot alteye, <br /> �_ ��G� � � �,!- � , loeate propoeed and all exieting <br /> � , bulldinge, ehow dietancee to prop- <br /> . 'I � _ . � � I i . •rty Hnee, ehow dietancee between <br /> buildlnQs. <br /> Lo! �Sce x <br /> •• � Lot area Sq. Ft. <br /> � <br /> I 81:a of Bldg. Sq. Ft. <br /> � Number o[ etoriee <br /> ' I � ' Huement . . <br /> � 8l`ned By Date <br /> • Tor <br /> � �Owner P one <br /> DO NOT WRITE HELOW TFTS LINE - FOR CITY USE ONLY <br /> Date Reeeived U�e Zone <br /> Plan Cheek Number Fire Zone 3 <br /> V�IuiHon � _�� � � Occupaney Group L <br /> Parmit Fee_ z C. ,1-c� Type o! Conetructlon v -ti.l <br /> Plan Check Fee � — � Oceuptnt Load <br /> Tot�l Fee Due Z 'T. J-�� , Sprinkler� Requlred <br /> Datel�eved � • � � <br />