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.� <br />/�.3a/ � -� <br />BUTLUING FERMIT APPLICATION � <br />i+pplicant To Complete This Form I 6/3/7 f <br />If more thm� one building is to be constructecl, submit a separate permit ap- � <br />plication for each building. A senarate permit wi.11 be issued for each build- <br />ing. <br />� '/r� </� . <br />�.Owner .�K> > r <br />Address � - � • <br />CitY. �vr he.� T ,Ph��� ��/ <br />� <br />Architect <br />City. <br />Phone <br />�Contractor n� J-F' <br />Address <br />City � Phone <br />� State License Number' �� ' <br />, Expiration Date � <br />/0� <br />. ��.,"`,1.`_�e� . . . <br />. �,.,_ <br />DO NOT WRITIi IIELOW <br />Date Received [Q L � <br />Plan Check Number.� <br />Valuation �Zp� � <br />Permit Fee ��Z� '� <br />Plan Cneck Fee <br />Total Fee pue ��7 f <br />Pcrmit NumUer�� � <br />Date Issued [�//�/-7 j � <br />-�---- <br />7--"— <br />Duildiny nddress �i ��Q� �__ ��E��hu <br />Lot1� Blk.�_ Sec.� <br />Tv.�. Rge. � <br />Subdivision (Plat)��. }c� �; i � �L� 4_ <br />T <br />Metes & Dounds (Unplal:ced} <br />Buildina <br />Describe S4orJ: to IIe Done /y�finG n .. <br />�°N fP+�� lD �.P✓in,q �_ <br />Use oL IIuildi <br />'_New l�ddition . Repair/Re;�odel <br />Valuation of Constructi,on $ �t6' <br />� PLCT PLAN 17(�' �� <br />Indicate lot size, name of�street�, <br />indicate locatioii and �eidth of <br />alleys, locate proposed and all <br />existinr, buildings, shoo� distances <br />to property lines, show iiistances <br />between buildings. <br />Lot- size x � .. <br />� �Lot area g,g, ; <br />Size of Bldg. S.P. ; <br />NumUer of Stories <br />Basement <br />Use Zone <br />Siqned By_ ' <br />Y For �/.z ,; �! <br />wner <br />TIiIS <br />Fire Zone <br />Type oP Construction <br />Occupancy Group <br />Occupant Load <br />Sprinklers Require <br />ONLY <br />� <br />�•� � 3 � -l'� - f��. (_ . - <br />APPROVCU FOR DUILDING PCRMIT <br />Dal�_ „ <br />