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<br /> _" �, .. � ' ,. . • • • ' � DUILDINC PEIiMIT Ai .':IC7ITZON • /'� .•�,rq ; ; : ,T
<br /> , . Jlpplicant Ta Conplcte Thi� :onn � �'f' "' � • • � •
<br /> .. . , � . • . � �/���7 7�; �''i
<br /> , • � 2! more than one buildinq is to be conl•ructed, suLmit a separate permi�_ applica- I
<br /> • . S tlnn for each uildin�. .� separate permit wi:l bc issued Fqr each buii�ling.
<br /> /� �.
<br /> . ' " Ovner _(� (',[,!/r� n _ i Buil3inq Address < � � ���."' w,�
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<br /> � , � • . Address �. �PJ�e ¢ Lot , ' /�/�
<br /> . � Dlock _(' ' •c� -DO-
<br /> � , . City l��J-Z.A'��Phon `1 � Subdi4ision (Plat) ���Qqpt 6-c�'�„�cL�a . ,
<br /> _ ' • Jschiteet/F.ngineer - � • � . ' • , � ,
<br /> ' '� � -'� Cit • Phone Hetes i IIounds (Unplatt:ed) '
<br /> - :.� . �1 Y -- .
<br /> �:,'. Contractor - Sec. . . �
<br /> . . ..� . . . 2t+P•--- Rye
<br /> `-' , ' ;' • '• R3dress h�/ 7 �. �-''Z`� . ' . . • .
<br /> . �-- �/�, .
<br /> .. ��; C;ty ��CJ' Phonq�-�/ Z Building Use ��'�u�p��fr-��• '--S
<br /> •�i . 4:�',L��.,.
<br /> �'�� � Statc.License N�er�� — Describe h"ork to Ba .Done ����r'Y '
<br /> : . ,1 �piration Date . , ' .
<br /> ' �� ' � � • SRE2'CH PLOT PL:,i7 BELOF7' � '
<br /> . � �• � '� • � •../IIse of Buildiriq ��r-i�,p�_«�/ �
<br /> ' . :•1 . • .. ,r . , .. , . /, . .i . � .
<br /> �' i ��(/L'Q.�j.;,�� . ;.,�„Q(,�",Ct�,�i, � � • I]New ❑ I�ddition �Repair/Remo6el '
<br /> ' � ' i• ' " ' ".�J� '9aluation of Construction $ / (� ' �
<br /> . ��!'1-Tz-c�.�.... ...�' .��1�-'o�e_;:�/ --�—�-�.
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<br /> "�-- ' ��� �'��,'�.�"�.�'J,�������� . �+/]�/�� � � �• ^ PI/JT PI.F127 REQUI?2&�fE,7TS •
<br /> 1� ''��%� ' • `. / .p � /"'�/vV a 1 . . • : .
<br /> T .• i �/�t ' ' �J!J ' 7.Iluicate lot size, nane nf streets, •
<br /> • _. ! 'i,�� J _ ' / < O:- � .. •in�3icate location and width of _ ..
<br /> f alleys, locate nronose,i a.^.d a11
<br /> • ' `' • � • � ~' ' '� existing buildiags, sho:a c�istances
<br /> . : � • ' '� �'��j!y'` ' L-o property li nes, show distances
<br /> ' � . ' : � „ . . �� �.., betwecn bui.ldS.ngs. .
<br /> ;• ..,�}c�7,.P (i(�����< ,. . Lot size x ' • �
<br /> ' j ' ' � , . I.ot azea ' Sq. Pt_
<br /> • r.. ', • • . • � . Size of Bldg. Sa. Ft.
<br /> � � 's - ' ' tdumber of Stories
<br /> . • :: . i � . - . . . . Aasement �
<br /> :.. . . � . —
<br /> '• _r • • '. Signed Bd )��-L�
<br /> a. . ,
<br /> . . � . , For / ��
<br /> .� - - . - . • . Ow •r Phon ��-S:.i t_ .
<br /> . � ..' . DO NOT Sti:iT_TE TJELOS�7 THIj L'L:dE-PC:^. l'ITY USE OiIL'! ' � .
<br /> �� /� �- .
<br /> : ' _ Datc r�ceived (U// '�I �, IIce• Zor.e � , .
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<br /> ' Plan Checl:. :lur..ber ' ' Firc Zonc ' �
<br /> O .
<br /> Valua�ion �O�CY�J�� Occuoancy Grou�
<br /> Pemit Fcr_ SZ. �'�� 2ype o£ Con�truction
<br /> Plan Ched: Fce � � ' Occupant Load • ,
<br /> . ? 7bta1 Fcc Due . S z- � Sprinl:lcr� itequired ' �
<br /> Datc Issu^_d %�i% � • . '. . ' , ' . , . :
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