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` 1�''� <br /> . Appltc.�r.c 'io c.cr.piccc i::u; . �,i�„ / ��� <br /> If morc than onc buildinq is to F.c cnntzucted, subnit ,i sopirate permit npilic�l/S� <br /> tfon Lor each buildinq. A sepai.:c� p�.�cnit •.�ill be issueJ `or each buil�inq. • <br /> Owncr `,�, " DUlI(:1Rcj Ac]OCC53 "�� : r :. � a.�,d ` <br /> T— ^ t ,. <br /> Addre�s __ ` " y �, �_ Lo[ ,S t ,:c _ Block S�'��� � <br /> City /_- _/%- Phone Subdivision (Plat) %� - _ - -- _ I <br /> Atchitect/f:nglneer ' � t- • -, j <br /> CitY _ Phonc M t�J�n s 'j�Ap1a��C�a7 ��T�_� ( <br /> ---/CT <br /> Contracior � ��, ,�.�c�i�,, � ', Sec. '1Wp. Rqe , I <br /> Addres.. .- /`� i / ' ----- � <br /> City /_� y Phone i 3%� Buildinq Usc /�! ; ' <br /> State Licenne Nunber �2� 3-o/-/�yn3i Describe WorR t�� Be Done ,.a. � <br /> Expization Datr .J�An- /y7� • ��,�. . • <br /> SR6TCH PLOT PL.1`] BELO'i <br /> Use of Ouildinc ' <br /> � �� ��New �Addition ❑ Repair/Rer,.odc1 <br /> � . Valuation of Construction $ .��� "" � <br /> ; • ' PLOT PLACJ (tGQUIBEDIL:iTS ' <br /> . /' � .' � i. ' . <br /> • . Indicatc lo[ siu, namc of strects, � <br /> t � � ` � indicate location an3 wiC'_h of <br /> allcyc, locatc propo_r;l �r.d all ! <br /> � exis[ing buildinqs, show distances I <br /> . � � to property lines, s}�o�r distar.ces � <br /> , _ betveen buildin3s. ' <br /> � <br /> i � <br /> . Lot size '�.�; x� <br /> , /n�_ .. Lot area Sq. F't. <br /> �' ' Si:c Of Oldg. I(, ic 1 y Sq. F:. <br /> � ♦� �, hu:iber of Sturies � <br /> i �.'/C/b�JLr�f-� I I C�'^'..C.^.t N.T....'__—_ _ <br /> : I I � . . <br /> '.'"_'___"_ .)".. II S]Cj:lit �� "✓ .�.. ' r . '/ � (_./_"'. <br /> I <br /> _"____"J_________ ' n �' <br /> �_��� T�' <br /> � �; / �9✓/��. , For <<,��' J. aT/�� <br /> ' oiancr Pnone ' - - <br /> ___ __ DO NOT W�ITB r?LC[7 _HIS I,iNF.-FOR CITY U5E OIILY <br /> ` ^n_. . --.. <br /> _ _ _ ---------'-- V.e �onc <br /> � . .� �'-cc'f. `lur. . . - -- <br /> � __]S_-�$_�_._ ___ Fite �onc Z <br /> �r_ -- <br /> valuation 4-, ��� __ Occuoancy Croup __� <br /> Pcrnit Fcc '� <br /> �SP 7yoe cf Constructian <br /> _.'-��---- <br /> .1� <br /> Plan Checl: Fee _ J �- _ _ Occu�:ant Lo�d — <br /> Tot�l Fco Dc-� ___ q-L , �W Sprink'ora Rrquircd — <br /> n,,to r ,�.��.,._i --7-�---� 7�- - CITY OF EVEf'�FTT --- <br /> p,p^rn�rE-�� I�Ci� ,",I!f f11i:C f�RP�11T <br /> '� / AS No'(� <br /> Datc�Lr���---�Y -� -c- <br />