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_.' � DOILDING PERMIT APPLICATION � (� ,i <br />- � ' . 1lpplicant To Complete This :axm ,�7'��� • "`! <br />,� �•' If more than one buildinq is to be contrueted, submit a separate permit applica='-S <br />.. tion for each buildinq. 11 separate permit will be issued for each building. <br />, y . . . <br />// <br />. � �.Ovner � 9 .�, ��(�.c [�_� Huildinq Address /-'/�/..(� ,�"U��. R-�/.` <br />� <br />' , llddress ✓lOi,f �C.<,��a.��_-L� Lo! � Slock . <br />City T.�n�e�„e� Phone :�5,� -Ol�/� Subdivision (Plat) �'/Za.�Ti,E.«�Crv� l��v <br />' • IIrehitect/Enqineer � • <br />•:� "'� City Phone Metes i Bounds (Unplatted) <br />- - "1 .. <br />. • ;, Coatractor Sec. 'R+p. Rge � <br />_ ., 1Ildress . • • <br />' City Phone Suilding Use L�r :Z' "� <br />:.� ,: • �� :: <br />� ��'� State License Number Describe Work to Be Done `�`��. <br />- rj <br />, . .. �I Lzpiration nat� Y6�� �,h--�` h'-��.�,�v . <br />SICETCH PLOT PLAN BELOlP <br />. <br />;IOT <br />IIse of Building i ✓ � � <br />L'7New ❑ Addition � Repair/Remo::el <br />:' pC, : <br />Valuat.Lon of Construction $ 25f� <br />� P7AT PLAN REQUIREFSEYTS . <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate pr000sed ar.d all <br />existing buildi:gs, show distances <br />to property lines, show distances <br />between buildings. <br />Lot size �7p x /%� e <br />Lot arPa Sq. Ft. <br />Size of B1 q. i Sq. Ft. <br />Number of Stories / <br />Basement — <br />��Signed By '.5 ���,. � ��c� ..���=_;� <br />v � <br />For <br />Owner Phone • <br />3 B�LOS4 THIS LI:IE-FOR CZTY USE <br />Date r�ceived �Z/� ��% 1 ^ <br />Plan Chec;; _7urSer %�'Z�I Cp ' <br />Valuation ��'S��� �� <br />, 2 ¢, O!a <br />Pemit Fee <br />Plan Chack Fee <br />• v <br />, � � 1bta1 Fee Due �1��• --�— <br />Date Issued <br />�� '`-(-�-�C(�il� ��¢/7�� � ." . <br />IIce Zone <br />�ire 2one <br />Occuoancy Grou� _ <br />Type of Constzuction <br />Occupant Load <br />Sprinklers Required <br />. . <br />. C;�1Y �,r , ,,�ri;FTi <br />1^ �;;�i ''" : , �' ,. � '('iii�:il���� <br />%//(p�7 � �Z' <br />