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1 <br /> , <br /> ` <br /> • , � BUILDING PEAMIT APPLICATION � � .��j <br /> " . ]1l+plicant To Complete This ?orm <br /> Yf more than one building is to be contruc`ed, submit a separate permit aFpliaa�- <br /> tion for each buildinq. �l separate permit •aill be issued for each building. <br /> � Owner L/d,�L'c7'AJ =�il•�5� FL--�J( rv'r` Huilding Address �S!C� �G'� l'�`�-'C l'-,i' <br /> ;� ! �' '; : p�-,N � <br /> , ]lddress Qr�U ��-'/vcCi'Si.!�c= Lot Block <br /> City '�ll<<^���- Phone Subdivision (Plat) • <br /> ]irchit ct/Engineer .��c_ i VfM <br /> :. .I ��OC> CU o--S:L.v ,�� Nui-T � . . . <br /> ::f City ;��%�E� Phone�J�c/-C�GC/C� Metes s Bounds (Unplatted) <br /> � Contractor �lk'KJ CU T!(�c.`=G.�1� �cZUS See. �� ZWp.�� R9e �-f- <br /> , <br /> : ]lddress ✓�� G�O� C'<=0•`"1-� . � <br /> - - � �y--3-qo�� : <br /> � C3ty 7���/•�?-•C�L Phone;3Z J�_`$JG Building Use �1�1���'�s "' � ��'��.: :1' <br /> ; ,� '✓ ,��=� •. <br /> - � �j State License Number � - -� �-��I� Describe Work to Se Done _G�N,�7.��li--� <br /> � , . . � 'I Ezpiration Dat� � "`���`��-���N�- <br /> •� ' � � - SItETCH PLOT PLAf1 BELOS+T' • <br /> . - . � • • , <br /> ' : � . Dse of Huilding <br /> � • . _ 0�lew ❑ Addition ❑ Repair/Remofiel <br /> ' ' . � . � • Valuation of Construction $ 1r�C�6L`����' <br /> ; <br /> ,,...• ` . , . . � • - � PIAT PLAN REQUIRFI�IENTS . ' . <br /> • ' , • Indicate lot size, name of streets, <br /> 1 • ' indicate location and width of <br /> ; ' alleys, locate pr000sed and ull - <br /> � �-'� � ' .. existing buildinqs, show distances <br /> •( •- �o . to property lines, show distances <br /> q • between buildings. <br /> � Lot si�e x <br /> , ,. � � Lot area Sq. Ft. <br /> . � . • � Size of Bldg. Sq. Ft. <br /> < ; N�unbez of Staries <br /> ; . Basement - ° <br /> .:. �. i '1 .� <br /> ` � •: '� Signed Hy �� ��%Cc� � <br /> . For ;�L,c,:� w ` (Lf.t�t(.=��°-�� � _ <br /> Owner �' Phone <br /> i �yS— r� <br /> �.�0� SNY►C1F) <br /> DO :70: S<:iI^_L 3cLOS'I THIS LI:IE-cOR CITY IISE Oi7L'f <br /> Dnte ��ceived _ S / 7`>� II�e 2one ���fet-�• � ��-• <br /> Plan C;1ec.: :tur.�ber 7�J -Z� � Fire 7.one ��J " <br /> Valua:ion��i�i �0O Occuoancy Grou� �Z <br /> Pemit Fee Type of Con�truction �(- ►,� <br /> Plan Check Fee Occupant Load �� <br /> , Total Fee Due Sprinkle �s Required V a <br /> Datc Issued � � . • - <br /> � . 1.� 's/7'7S ' <br />