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--.. _ _. ..— ---- -- --- � ;� <br />__ - -- _ _ ._ <br />----.._.-------- ��/i/ <br />� <br />- � BfIILDING PERMIT APPLICATION / �� � � f 3 �y <br />� App1: cant To Complete This ^orm ����, / AAr�s �/_ �:� <br />J !u �Y/t� I`l <br />If more than one building is to be contructed, submit a separate-perrrit-aE�iica- -;' <br />tion for each building. i1 separate permit will be issued for each huildin�^ L� <br />1' , Lc1�F-/2F17 <br />Owner %'�!<n.l�� r���• �V ' Building Address �r�7 �Ca. r3/2�lS�Jw/� y <br />Address ��-� 1121i�F��C.17� � ��d Lot Block <br />City ��F���� Phone 2�' � U Su ivision (Plat) ' <br />Architect/Engineer'��- 7 G �Ni���'�• <br />/� � Metes s Bounds (Unplatted) <br />City L-�C'i1T'iL Phone la23 � 6445 <br />Contractor Vl�l�.fG ( D�J57� C_b. Sec. �V �'P•Z� Rge � <br />Address ( ZLi M 35 =� . <br />,1 ��roic. �razF.�' <br />Citp F 7I� = Phone F y• $O Suilding Use �' � <br />State License Number 223'U��`�B$(� Describe Work to Be Done ' <br />Expiration nate CGN�TI��i /�FIA� `�-N'd�CJ7 Sn�C�' <br />SKETCH PLOT PL71C7 BELOW <br />tiG <br />\'' ^� , <br />�f I <br />�� <br />° f� <br />��; .� , <br />� � ti�' <br />Use of Building <br />�New ❑ Addition ❑ Repair/Remodel <br />A;�x � <br />Valuation of Construction $ i�n/I� <br />—��pv� <br />PIAT PLAN RE4UIREI�SENTS <br />Tndicate lot size, name of streets, <br />indicate location and width oi <br />alleys, locate pr.oposed and all <br />existing buildings,.show distances <br />to property lines, show distances <br />between vuildings. <br />Lot size X <br />Lot area Sq. Ft. <br />��� � Size of Bldg. Sq. Ft. <br />a�� Number of Sto�ies <br />Basement <br />Signed By M�. 0 � <br />ror �C1GIL/1 S [lL(/t1.G4U�j �2Gf�_ <br />Owner Phone J <br />a <br />DO NOT WRITC BELOIP THIS LIidE-FOR CITY USE OC7LY <br />Date ^xeived U_e Zone � � <br />Plan Chec:� Nunber Fire Zone �� <br />� " <br />Valuation � t'riA Occunancy Group G� <br />ary � � �' I`1 �� �r'�u1Kl.i-T7 <br />Pemit Fee 2�q a� Type of Construction _� <br />Plan Check Fee Occupant Load �'�� <br />Tot.sl Fee Due L��'� Sprinklers Required t.r+y� <br />fr <br />CITY 0; �1'ERETT <br />Date ISsued n��;r��;�.- i-- - r r- <br />n, � � ���:: ��.;;,_� , ��;Mir <br />��.%��.,,�� � l" �-�� ° '-�!i ��'���� �/ <br />� � <br />