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<br /> � ;� • 1 •• � ,'- , . • � �OILDING PERHIT T�PPLICATSON . �. � ' .;: �,,.., /�� 7
<br /> j � � . �pplieant To CompLete This -orm � r �
<br />, ' . , i , ' • �SG75 �.
<br /> � � =i �ore than one buildinq ie to be contructed, submit a sepaiate permit app ca
<br /> • ,• ; tlOn foe each bulldinq. 11 separate permit will bc issued for each building.
<br /> '. � ' Ornet Mg,+,M QS.� 1�) a`1. L � ��_ lnlldinq Addrese �222� C1..l:�U fxNU�. � .
<br /> , .: ' �+CSS G"l�� R n,�;��=R �j r LOt S10C�C � ..
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<br /> '� Citp �1Lh'GTT phone_ 8ubdivision (Platl '
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<br /> ' ' iishitect/Enqineer 1 .� ' '� � .�.�'i
<br /> _ •t�� . `._�' Citp CUV.��ph�a �� -G lletes i Bounds (Unplatted) ,__ _ '
<br /> ' ' Cantracior l�7 t-::LiS. LiJ ec 1�����lae. 'r+P• �?° . -.
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<br /> ' . _:• �• �ddress '2:'�G �.. UIRGIFJC�i ' . •
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<br /> � � � ctcr � r���l"T Phonn �9 ����0 lnildinq Use :.L3:'...
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<br /> • �.+.��� iRata.License Nmuber 'Z'�3 �V� "��8 �'3 �acribe Work to Be Done F(Z't, �G�'.C11��,t
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<br /> . . , • ��;-.1��,• tz►�rk C��PLik�.��.
<br /> . '�. lapiration Dat�
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<br /> �1: �"• � , a�CR PLOT PLAN B£LOTQ' • • �
<br /> .. . : � ' � . : .: . • .�re (,_ s
<br /> ��'. • .. . O�v of Buildinq �
<br /> : . .j�pQN ❑ Addition �Repair/Remouel
<br /> � � • . � ,, . . . . . �. .. .
<br /> • • '.. .;.i' • : • . '•. � � , , . ' �, . �Valnation of Construction Sz.�l) r7 v
<br /> i ' • • • � . . lLOT PL71N REQUIREI�ffiNTS . ' r±
<br /> `. � _ .. . � • • .
<br /> : ,, � : ' , • .• � • ' indicate lot size, name of stzeets, '
<br /> • � t. �• •in83cate location and width of
<br /> illeys, locate proposed and all
<br /> ' �'� � -• �� � • ' lxisting buildinqs, show distances
<br /> .. .•• � .
<br /> :�� .._, ,:,y ,+� tp property lines, show distances
<br /> . �''� • ... � .. w . .. between buildings. • :
<br /> �. i . ' � , ;
<br /> • , , • Lot size x
<br /> • , . - �'. ' ' • Lpt aree Sq. Ft.
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<br /> ..i- . .� . ' 6Sze of B q. �__ 54. Ft.
<br /> ` �• ' ' tiumber of Stoues _
<br /> .�� "• • � ' • 8asement �_�,�___
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<br /> � .�'.•:� . Siqned BY �'�---
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<br /> . 1. � ." ' . . . Tor _
<br /> • • . . . Owner Phone �,_ .
<br /> . � �• p0 NOT h'7ITL BELOl7 THIS LI:1E-FOA CITY USE Ot7L'! �
<br /> —. . Date °eceived � S� Dce 2one
<br /> ' Plan•Check t7ur.ber __ Fire Zane
<br /> Valnation S¢�• �� �ccuoancy Group
<br /> ' pemit Fee C�• �� Type of Construction _
<br /> • ' Plan Check Fee Occupant Load
<br /> • � (�• m� Sprinklers Required ^
<br /> , ,: Total Fee Due ,
<br /> ' ' � tQ/s/�S� . .. . . . . �
<br /> Date Issaed . . • , ' ' . , , , �
<br /> ti ,.. � � . 5�. � . .
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