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e <br />. , • 11UILDTNG P13RMIT APPLICATI014 . �y� ��� • <br />• Applicanl To Com��].et•c 7`1�S.s, l�or.m ' -3y� <br />3�5� y <br />If more zhan one buil.ding is'to l�e consi:ructed, submit a scpar.aL•e pe��mi.t <br />applicaLion L•or each buildinc�. 7+ separat•e pern�it wi.11 be iscued for. eac:h <br />building. <br />04mer FlM2� �M��E� IIuilding Address �4Z�i �Uti�2fv��t�l W% <br />naare�s ��z� cv<<�6�Z�t�� w,� .. �,oe nio��; <br />City L�4t(�4�T Phone 353-7�`iS SuUdiyision (Plat) • <br />Architcct/�ngineer "�� <br />City 4n14GG�,ti— Phone Metes & Bounds (UnpleitL�d) <br />ContrccLor ��,w�A�nL� (�.3i , Sec. Tc��p. Rgc. � <br />Addre-ss �0 �D�t. �t��(i _ <br />Citg r�itleL��C� Phone 2S - 1�1� . <br />State Licease b?umb�er b-ISZ4y�'7(; <br />Er.piration Date o4, - 3e - �(� <br />CO1��T�.�' PlOT PLAIJ OPd }?EV�ItS� SID� <br />� <br />s <br />Building Use -�jI�1Z�bi. _ <br />Describe Ylor}: to Be Done 4 <br />/�-D� W� D i�ernN.tit <br />Numher oi Stories <br />BasemenL' <br />' Ide�a Addition 12epair./Remodel' <br />ValuaL-ion of Construction $ y.>eo <br />i <br />Signcd IIy <<�zz12 s� "'�C <br />For <br />Owner � Phone <br />� <br />• Do I'ot I•;rii:e 13elo�a 'Chi.s Li.ne -I'or City Use On <br />Date Feceived " ' " � <br />I3].an C�ecl: Number ' • <br />Valuation L.�Scc� ' • <br />Pernit Fee �� � <br />Plan Check L'ee I`1'! <br />Total 1'ee llue �4� '% <br />Datc Ts�ued <br />Use Sonc <br />Firc �one <br />Occtipancy •Grouu _ <br />Typc of Constiuction <br />Occupant Load <br />Sprinlclers Required <br />V JJ � • / <br />� " _2� 3%���� <br />. <br />