Laserfiche WebLink
�. 'C 1 . <br />• . • DUZLDING PI:R1•:I'i .",FPLZCA7`T.OP7 . � � y� �� � • <br />' ' APplicant To Co;npJ.eLc Thi.s I?or.m 1/�� ,�', <br />. . �;'i/;.F <br />If more than one bui.ldi.ny i.^,�to he con�tructcd, :suUmit a separ.�to per.mi.t; <br />application for cach building. A:,ep�irate �>cr.mi.ti wi.11 be ZJSUCC� f-o�n- cac:h <br />building. ,222a /; Ir�qX �}Jp, <br />i�mr.r Y��'cc,Y '�'�J�:./=-`��CO�(��:��IIu•ildincJ ndclres� �=l� � <br />Addr.ess �� /r' PJ 2: �.: y�, Lot � 137.oc): / 2- <br />Cit,y �.�--,.-�� Pho:ie 3Sj U���-� Subdivisi.on (Plat) //...�,_P� N7'� <br />Architect-/Tingincer ��d-c / d `✓���`� �� ��•S.%s ��i <br />City Phone Metes F< I3ound� (Unplattecl) __ . <br />ContracL-or '��:z-�- ��'w'�-��'"�-7� .-�''z, Sec: T�ap <br />Rddr�ss � i? �/O 1- /o� <„ti 9 �-Xo , <br />� T f� <br />City `�/L'--e-.•-c�i'-� Phone �� � � -'- �� <br />Sta_c License tdumber 2�-3` to// E iE3 � <br />Er.piration Date (�>-% ��% �� <br />C0;•P?.=": FLC3 PLf;t� Oi,t RESs:�aE ST_Il�' <br />r, <br />�� L .�GEZ`�� l <br />P.c7e. <br />Bui ] di.nct Use � ;f%,+�ccK ,�2��0'.-"�'� <br />Descr.iUe Ylor.1 �_/one <br />L��i-��- /J�-W /�d-� -�---- <br />Tumber of Stories l <br />IIasement: � 0 <br />�_ �r; �Addition Repair./I:emodel� <br />�_/ �nc� <br />Valuation of Cons��ruction $�9G+oo- <br />. . Signed IIy i� i-.-�� 'L .._� <br />. For <br />Daie fieceived <br />Ot,mer • Phone3S�� f'J`�7` <br />Do 1?ot i�;ritc l�elo�•: 'Phis Li.ne -I'or City Usc: On <br />�lslan Chec): t:umner %C��`ZD <br />Valu>tion � cl���� E'U <br />Perr;it I'ee % �L l%. �'�' <br />1'lan Check I'ee L�OZ `'v <br />Total Pce Due /g(p- �- <br />Dat:c Issued <br />" " ' • � Use Sone <br />rirr. 7,one <br />Occupancy•Group i <br />'ia�pe of Con �i:r.ucL-ion <br />Occup�,ni: Load <br />Sprinlc.lers Requir.ed <br />� <br />