Laserfiche WebLink
_. • . � ' DOILDING PERMIT APPLICATIOY . • .,,:� - <br />� " ��• • � � 7tpplieant To Complete This =orm ' % 9J� J <br />,�4`" �If tare than one building is to be contrueted, submit a separate permit appli.ca- <br />, tion fn� oac!? building. A separate pezmit will be issced Eor each building. <br />. ; ' aner �/l Y� /��.5 /J/C v G S Suildinq Address ' � .�.�.�_ y � �-� <br />'f0-Ni -r z �t 7 <br />_ �ddr�sa !o� �,1 O fG,�� GhFEni [liiF✓ "l.�' Lot /'7.-3-�( Block � - <br />City /z L•r=/LF � Phone - ' Subdivision (PYat) ��=U /fit c _ • <br />' - )schitect/enqineer � � /JI v__rt 3 � ' <br />`'� City � Phone ttetes i Bounds (Unpl,atted) <br />- - "( .. <br />. . :, Contractor ��` .S �an -�i - See. 11+p. R9e � <br />: • ' ]ddress / 3 ! �7v �,� G�-z , '� . <br />� <br />!, City `� � Phane �G5 oz�/ Z- Bu3lding Use ": 'i�',,.,.. <br />�j State. License Number ;��3-O(- lN�o ii Describe Work to Be Done _ �` � <br />� • . �t L:pization Dat� � Z N ST/f � '� ��$ C/�1-' � <br />:1 : '" � . SICETCfi PLOT PLAN BELOW � • � <br />: ' :.� . • . . . IIse of Buildin4 Q,z T//i� - � . <br />a �/�� 5T1,' �. �- ; . �.�� 5 � (!`1 �.L/. , �New ❑ Addition Q Repair/Remociel <br />� . .• '. � k/J6,� � o F� /�ooF�� ' /G�` : /?/�//' ' ,O�nation of Construction S '7��� n" � . <br />. � '. %%�/1 N . . . . , � � " PLOT PI.AN REQUI?2EFIENTS . <br />.�- ... . . . . <br />.. � � . <br />� . r <br />�-• • _ • Indicate lot size, nane of streets, <br />' � • '' �indicate location and width of <br />�.' , f " . _ . , alleys, locate nr000sed and all ' - <br />. � �• � existinq buildinqs, show distances <br />_ ; � � ...-. '.- r• �c � . ' ,.''+ • • to pzopecty lines, show distances <br />� , • � • . betr•een buildincs. <br />� ' , _. . , <br />. . • <br />.... � <br />° r. " <br />.; <br />. '.: i. <br />_.. _ . <br />• '�- <br />Lo': size x <br />• 7.ot azea Sq. Ft. <br />� Size of B d�g. � Sq. Ft. <br />Number of Stories <br />Hasement <br />Signed By -/�r� � �� s�s �4� � <br />� aa= ,/� ,. D.� �u.�,o <br />""�" er one "� /,.1- o � t <br />� �➢0 NOT S4ZITT' B'LOS7 THTS LI:IE-FOR CITY USE Oi7L'L <br />Dnte S�ceived Dce.Zone ? __ 2 _ <br />Plan C:zec� :7ucber � �' Fire Zone 2- ' � <br />Valnation Oecunancy Grou� � - L ' � <br />Peznit Fee Type of Constx�uction �..�a . <br />tlan Check Fee Occupant Load _ <br />Total Fee Due Sprinkizrs Required <br />. GITY 0 <br />Date Sssued • . .•APPRQVED FOR F3U14�ING PERMIT <br />. ' • . • Date:�=/ �� '1 � QY,—� - C'--- <br />