|
__ ' ( , , , .. . DOSLDING PCRHIT APPLICIITIUN � .., . ,,. �/-..�j y �:� ,_
<br /> t � � � ltpplieant To Complete This :orm � '�•" �' ,�
<br /> . . � . . � �H�7s',
<br /> , • • If taora than one buildinq Le to he cuntructed, submit a sepazatr permit�pplic�-
<br /> . . tioa for e�ch buildinq. .1 separaC�e permit ��ill bc issucd Lor each buzlding.
<br /> . � ' f�r�cr FRANk 9` /%'Fc� LO::�G Euildinq Address �� 3:Z2 CI��STNUi , �
<br /> .� • � Jlddress � 3�.1� ��H�STNG�i Lot ?`� Block �E� I7-D�
<br /> � � city EVEREIT Phone ;-L5,2 -o3�L Subdibi.ion (P.Lat) DIV O :
<br /> � • drehitect•/Enginccr /�IUNE � • • •
<br /> _ •,'�+ � `_`� City � Phonc _ ` Hetcs s Doun ^ (Unplattedl ' •
<br /> �;� . . � � _
<br /> ;,•: Contr.aetor ' /UQ PIE ' Sec. 'Arp. Rqe
<br /> - � • . .
<br /> =• ;• � ].ddress ' • . . ,
<br /> � '�' City — Fhonc ' � BuilZing U�e � RP��r�T STO%A(',�i� ::r'
<br /> � ri � SWte.License Ncnlier _ '�— � Describe Y1ork to Be Done �u/e,n . �` ',
<br /> � : �I Ezpiration Dat� _ �
<br /> *��' ' , • SF.ETCfi PLOT PLA?I DELOtJ� • .
<br /> - .;•,: i . � ^LLEY � ' Uce of E�uilding G /? Of�T �%���C� _
<br /> . .� L ��� v g
<br /> . . ..• • •
<br /> �•. � o � R � . � , ,,, � • L�NeH (�I�ddition ❑ Repair/R�no::el
<br /> � 4 V (+ .. � ' i
<br /> "�f E y.� , • • Valuation of Construction $ ��- .�
<br /> I �
<br /> �... , � � �qR .' - . PLOT PLAN REQUIRESIF.::TS , ��
<br /> ... . P . . . � . . ` �..
<br /> � :. f • • �f'•/. ' ' , ' ' IRdicate lot izc, na:�e o£ st�ects, �
<br /> . y '++ ' � ' ' •indicate oc�at'ioi� ar.d width o� �
<br /> • . � � � i� j�• • aYleys, locate nrocosed a:.d all ' .
<br /> • �• �- ` ' . • exictinq buildinqs, sho�.+ distances
<br /> , j � • h � ' H ,� . ' . ••!�� • . to Yroperty lin�=s, show distances
<br /> 0 between buildings.
<br /> . � � ' � g � � -• ' � 1�5 ' � . ,
<br /> � ' � • c� 5 �, • :' i.ot size C' x
<br /> . � r •
<br /> � :.i- ' � � . . Lot area ,j Ot�n' Sq. Ft.
<br /> . - . r, • � � . Sizc oI a11c9• L, E l7 53. Ft.
<br /> �'i :• i • Number of SCories o�y�___
<br /> . • :. . � f f � , • ' Dasement M O
<br /> '�!'. . Signed ➢Y ��UZ -C►�"`'�
<br /> • ,�- ' ' 4oF�w�or Q iT ��� ✓
<br /> • � HESTNVf � �� , ' Owner Pl�onc �S"�- ,_-�'?Gi
<br /> ,. ' DO NOT P'YITG 3ELOf7 TFIIS L7:7E-rOR C7TY USE OilL'L � �
<br /> • Datc `:eccived l- ������ �.I D�e Zone • , �
<br /> . . - � �
<br /> ' Plap Caeck :7ur,Ser � � � ' � ' Fire Zone �� '
<br /> �j�; � �
<br /> Valuation ��d�• � Occuoancy Group ^ .] _„_
<br /> . . G
<br />� Pemit Fco �.CJ • ��' 'Pype of Con�tructinn ,�`�L - I—� .
<br /> i Ptan Check Fcc — Occup:�nt Lo�d •
<br /> /' r Ci v
<br /> , � 1�ota1 Pec Duc LL�� G�+rinY.lcrs li�N4r� F��,mT� '
<br /> Datc issucd •��l 4�/> � " ' APPRQVEU fOR {3UILUli�G PERN➢IT
<br /> � � • ��� • • oite_1�i__L1;.,.:._By � � '
<br /> ' • . � , .
<br />
|