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i <br /> � <br /> � BUILDLNG PERA4IT APPLICA'PION �� � j�y� � <br /> • . Applicant To Gomplete This Form ' �/� �/� <br /> • If more thaa one building ie to be conatructed, submit a aeparate permit <br /> . applieation for each building. A separate permit will be isaued for each <br /> buildin'g(.� ^ <br /> � Owner ��"'�� �� � � �"�uilding Addreee �� ' <br /> v Lo 3�f Block f(� <br /> Addrees /� n ,� ,� n ' <br /> City��� ��� �.�p �bdivision (Plat) ` 'r�n S�hn_Q�a� �-d� <br /> �Fnone <br /> Architeet/Engineer-� I, <br /> -�- '�_ <br /> City Phone Metee & Bounda (IInplatted) <br /> � T Range_� � <br /> ec. �'P•� <br /> Contractor C�CI�. '--- . <br /> pddre s y��`� <br /> Ci �' �' _Ph°° r��ilding Use � <br /> State License NumbenlY7ti�I"II`7���'�Deecribe Work to be Done <br /> Expiration Date �- � ` ��� � � ��" . � <br /> SKETCN PLO'I' PLAtQ I3LL0\V , I <br /> Use of Builaing �����`�� Q • - �� <br /> � � New ❑Addition �Repair/Remodel I <br /> Valuation of Construclion S �:]�^t�5 � C� � <br /> � PLOT PLAN REQUIREMENTS <br /> � Indicate lot eize, name oi etreels, <br /> indicate locaCion and width oC alleys, <br /> locate proposed and all exiating <br /> buildings, show distancea to prcp- <br /> erty lines, ehow dietancee between <br /> buildings. <br /> Lot eize X <br /> Lot area __Sq. Ft. <br /> Size of IIldg. Sq. Ft. <br /> Number oC stories <br /> Hasement <br /> tgne Date <br /> n r�A Q��--� <br /> r 'z <br /> ._ -— -- Owncr hone_ J�)���� <br /> DO NOT WRITE BELO�V Tffi5 L1NE - FOR CITY USE ONLY <br /> � <br /> . Date Received 7 Z-4' 7 � Use one <br /> Plan Gheck Numher _ Fire Zone <br /> � �?J \�$ Gc, Occupancy Group <br /> Valvation <br /> �j C CG�-? Type oE Consttuction <br /> Permit Fee �---� <br /> Plan Check Fee <br /> Occupant Load <br /> q � Sprinklere Required <br /> Total Fee Due �'L^ ' <br /> Date Iesued � <br />