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=- � --_ ___ _ -- - -. . _ _ .. . _. . <br />- -- __.__ ...--- - ----- �- ------ - ,..._ <br />' BUILDING PERMIT APPLICATION /��(/ <-'///����^ <br />Applicant To Complete This ?orm ��/'�� <br />// � <br />If more than one building is to be contructed, submit a separate permit applica- <br />tion for each building. I� separate pennit will be issued for each building. <br />�e1 � a+'�� �,l�/�.� ��% Building Adaress �S � � � Fj ��„(�,J <br />Address �5(„ JCf_ IYt'C�u�'„ d�% Lot ��.ii�L- Block <br />City <br />Architect/Engineer <br />Phone <br />Sutdivision (Plat) <br />City Phone Metes 6 Bounds (Unplatted) : <br />i <br />.._., _ <br />Contractor ,' l � r � .(;!.l ��. . sec. � _ Twp.�' � gqe _� <br />✓ <br />Address � �r �'� � � <br />�' '� ,. _ C '_ <br />CitY r'�.' . -- Phone .ir—' •, �; �$i�lding Use ny. ' ��/I � <br />, ��- <br />State License Number ,.)_ r��� ,• � _� -; pescribe Work to Be Done �; -%,; .-� a�*=— <br />Expiration Date l � � ��--� � . " . , � � <br />SKETCA PLOT PLAN BELOW <br />� •• <br />Ose of Building <br />�New ❑ Addition ❑ Repair/Remodel <br />Valuation of Construction $,! � �'� � <br />• • PIAT PLi,N REQUIRE6fENT5 <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate pronosed and all <br />existing buildings „sho:v distances <br />to property lines, show distances <br />between buildings. <br />Lot size <br />Lot area Sq. Ft. <br />Size of Bldg. Sq. Ft. <br />Number of Sto�ies <br />aasenent <br />Signed By ���,,,,n,vZl %/.vr,t�Lt�,�,/ <br />For _,?(L„ti,�[,v,/ �1,.�,/i�� //�,�v�/�'...0 <br />Owr�er Phone � ��2 <br />DO NOT I9RITG DELOI•I THIS LINE-FOR CITY USE O[1LY <br />Date ^�ceived __��- � �- 7� U�e 7.one <br />Plan Chec:< :iu�aber %�- �6, Fire Zone � <br />Valuation <br />Pemit Fee <br />Plan Check Fee <br />Total Fee Due <br />Date Zssued <br />Occuoancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers Require3 <br />CITY OF ENERETT <br />APPROVLD f0i2 [3U1! Dli'�G PERhAI� <br />��.,« <��9 �,; -tf-c= <br />