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i <br />, <br /> _ . � � ' . ' � ' � EOILDING PERHIT APPL2CATION . �. � � , �7 /r�} .� ' <br /> . �pplicant To Complete This ?orm • � ��/ / ' r,'�/ <br /> . . � . / <br /> ' It eore than one buildinq ia to be contructed, submit a separate pexm,it appl3e�fJ' <br /> �' .. �L1oR for each buildinq. 11 separate permit will be issued for each bu«�lding. /5 <br /> u. <br /> . ��'Amer �� o n �,I cl. i-� I t �F , n e r� Dnildinq Address � (. �� 0 I F-,/�, 4� 1'1 r;c.�1 <br /> • : llddress �- 3 � � �i i ,_. 4 � �'I.�c �. Lot �'� 7 Block . � <br /> + <br /> ' C1ty �- ��t ''�. �t Phone 3 `� � F�`;�'� Subdivision (Plat) !�i � I n n�{ (_s f ef� <br /> ' ' �rehitect/Engineer `� �.- � � � ' <br /> _ •` � . `_'� City Phone Metes i Bounds (Unplatted) _ <br /> � ' - ' Coatractor } �c � � ' See. ivp. ' Rqe <br /> ;� , , <br /> � %.'. �� lddress <br /> .. <br /> i. City Phone Bnildinq Use R�s � c��z >,'�i n { . -.:-v;:. _ <br /> .�'�} �� State.License Niaober � � Describe Work to Be none� `���`��Y <br /> • • :1. LzPiration nat8 I��,�.- <.��� ...� r} ...�o�,� �{n d <br /> ��' '� , - . SRETCfi PLOT PLAN BEIAW. �. . �o,r� �� �^o o�'�; ' - <br /> .•-.. .:� , - ' , ' . . . ,.. . . � . IIse oE Buildinq �e•., i�En"F��� ( t . <br /> � ' ' ' , � �Nev I$,Addition Q Repair/RemoGel <br /> . . . .;' - . . . � , ' • - � . � � ,7n�. �• . <br /> • j . • . . , .. • 'Valnation of Construction $ <br /> �. . . .. . . . . • � � PLOT PI.�N REQUI4£FI£NTS . . <br /> r.. � . . . - . . . ' . <br /> -,�. � . . � . .� � , <br /> � - � • ��t . �. - • . . - ' Iaditate lot size, name of streets, <br /> � '� i � � � . � � � � � . � - ' ' •indicate location and width of <br /> � _ . "- ��, j - . . " .� - _ - • alleys, locate pr000sed and all - � <br /> _ .. ;.� ' � � . � ' : . _ ? � ' existing buildings, show distsnces <br /> ` --..� . h - to propezty lines, show distances <br /> ' : �°t • � '.� �. � _ : � betveen buildings. � <br /> _ , _ : . , - . I.ot size x <br /> �. � <br /> s . � Lot area S4- Ft- <br /> ..:- - �: . � � � . � . Site of B dg. Sq. Ft,. <br /> .t �' � Bumber of Skories � <br /> .� � . . � • 8asement C.-aµ;� S�.c�. <br /> �i:. Ti /, <br /> `.' •_ � : abiqned Hy��r-x� C� l� NOt �o � <br /> • +. , :' . • For ��F"�^,�JG4 � './0-e_��.�cn <br /> • � ' � � � -� � � � � Owner Phone 3 5 3 -:`� � � <br /> � � � � DO NOT k'ZITS H�LOCI THIS LI:]E-POR CITY USE Ot7L'I � <br /> -- � Daie ��ceived SI9I75 D�e Zone <br /> � � ' � Plaa•CSeck :7urber ?S''235 � Fire 2one 3 ' <br /> Valnation 7�,,,�Q�• _� Occuoancy Group � . <br /> • . @� • <br /> ' . YemiE Fee -��• � � lype of Construction �' ��_ • _ � <br /> O . — <br /> �. ' ' Plan Check Fee 20 '� � � �Oewpant Load � � <br /> : ibial Fee Due �!!� � Sprinklers Required <br /> • � CITY <br /> Dace Issued S/T /s �7)�_ . ' �• APP}20VED F.OR BdILDING PERMIT .� ' <br /> ' , . � . , �. , � 6ate-�4_� 1J_.$y K. E. � <br /> i <br /> � i <br />