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� ' . ' , . rr rru.v ♦y�u�a♦ �iCL1�.t111V1Y . -. � �• � •. �L.Y� <br />- � � �, , • � 1lppli�.ant To CompleCe This : orm / 9 � �(�' � ,� • <br />. ; . ii/ a`j,: <br />, • 3f aore than one 6uil.dirg is to be contructed, sul�mit a separate permit applica- <br />.: tlon for each buildinq. T separate pe:rmit will bc issucd for each huilding. <br />. � OYnes 1�67P,�'��G %�••�1//JSOlL� Suildinq nddress � l� 2 2�!//irE6fi'erF.C'�:sy'� <br />� . � . � � uaress 1 �Z L %c%�ilG�'/-'„✓ �c�i/ r.ot .1�0 �° /� Plncx 2= , <br />-. , CitY FLf,e'Ei 7' Phone 55�3 ��5-� Subdi4ision (Plat) . <br />_ ' lschitect/Engineer � • y�U� " 00� -'G%/C' —aD0 6 � • � - <br />_ .• z : . -.i City • Phone Hetes S Dounds (Unplatted) V �' • <br />:.� . . , <br />, _ �_ . .y <br />_ :,•; Coatractor � � L F ' Sec. _� 3Wp..� � Pge �_ <br />_ ...� . . . <br />- � %, :'• ?ddress � ' • <br />� � �.�f City _ Phone Bnilding Use ��F/ C � ' � • .:_�'�•,; "� � <br />•:� i ..;: . . . <br />•- � �'yf � SWte,License Nw�ber bescribe Work to Be.Done ,�n�''.f <br />: : • �i Expiration Dat� • ' • `' � <br />. � ' � ' - SRET�CF2 PLOT PI.�N B£LOIP' • • . ' ' - <br />� . . � • .. . <br />.t._i . . • �., • � '. : <br />IIse of Buildirig <br />--�� <br />a ` ; � � .� ; � � � . �,;, • New ❑ Addition ❑ Repair/Remo�el <br />- • �.i . . •�[Y ,.•'. -.,(�!'.�� ` ..i <br />� � T�� : : . ��rx� °� <br />;• ,'' Valuation of Constrn:tion S � � <br />A.! '{�� ..�!..... . � : , <br />` '._ . � . - .:�. ��j� : , . : . . '. � _ PIAT PI.AN REQIII?tE�IE:ITS � . . . <br />� - � �. : .:' . � .i <br />l <br />!•• ' iIIdicate lut size, nr .ie of streets, � <br />; . r3� �'/�' • �, �� : � <br />- � : '� .: �: : ��. fi���L -indicate location�and wicth o� _ <br />� r••,C � u alleys, locate proposed ar.d all <br />• ' �'�i _ � .'.�/�C��-1:- • cxisting bcilci :gs, sho:r distances <br />_ � 3'� " ''" –'-'� ' . „ ' • to property lines, show distances <br />• i . ' •: � � . ' .. •�'. betWeen buildings. . <br />' �/,�/�7° I.ot size x . + <br />* � �. �• . f ` "" +" /¢Z ` . . 1 . . .. , , . <br />� • �t ��t area � Sq. £t. <br />. "� r. �. • ..` ,:.. . . � . Size of Blcg• �_-7 3 G Sa. Ft. <br />� `3 '. • ' Number of Stories � <br />. • ' :: . � - . . .- ' . . Basement � <br />� rt'.: - _ � . . • ' • /, <br />� ;: . � . . •. . , �igned By ; i✓tGG� �-�_ <br />. ;.- _ . . . .' . ... For i <br />" Owne: Phone <br />- • . . �' . <br />. Date ?:�ceived i��3 �7 1'` <br />, _ _ —T <br />' Plan Caec� `lur.ber ' ' <br />�• Valuation � y�� � � � <br />. . ..• -- � � �� <br />Pexnit Fee ' <br />Plan Check Fee <br />. � Total Fee L... C ��• �� � <br />' Datc Zssucd ' - � 'T''�. <br />• �. . . <br />e <br />< � � <br />POR CITY US 027L'i' <br />Dse• Zona <br />Fire Zone <br />Occuoancy Groa� <br />^iype of Construction <br />Occupant Load <br />Sprinklers Required <br />T .• , _ <br />, • • ;.. . • • . <br />.. �^ �'• <br />. <br />0 <br />