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r'-. . <br /> - � � . SOILDING PERMIT APPLICATION � c� -7 <br /> . . , llpplicant To Complete This ?orm //. �5 pD '''�I • <br /> , • ' 2t more than one buildinq is to be contructed, submit a separate �/�% <br /> • : tion for each building. ]1 separate permit will be issued for eachebuildinqlica- <br /> � . <br /> �\ �e1 • Huildinq Address <br /> � . 1ledress pv .f . .�703 ��Q/�L19✓.4//F i <br /> • /E�'ii 3 w� iv�tci� � �t ,S _ a�o�k �_ . <br /> City � <br /> hone�(�+g-ZOZ7 Subdivision (Plat) <br /> _ � ' llrchitect/Engineer � �Q/d_�/ j �yD t <br /> :..I . !�P . <br /> _ _ -� City Phone Metes i IIounds (Unplatted) <br /> :, Contractor .. <br /> .. Sec. �, Rge . <br /> . . address • <br /> ^�: �t3' Phone Huilding Use . � <br /> . I .. ,: .. _�• <br /> • ;j State License Num6er Describe Work to Be Done <br /> .(. <br /> ; �i Lzpiration DatB ' ��jet /e,�/� �� , <br /> .1 : . . • /G �N�E <br /> � , ' SKETCH PLOT PLAN HELOW' • <br /> • . I . -- — .. - <br /> � i � <br /> : q • IIse of Huilding • <br /> � .. . .� . ❑New <br /> . , . , ❑ Addition ❑ Repair/Remo::el <br /> � ' ' ' • Valuation of Construction $ / d� " <br /> . • <br /> �"' ,� � . . . . . � � � , P7AT PLAfI REQUIREb1E:ITS <br /> .. ; . . . . . . . <br /> '. ' 1 ' , Indicate lot size, name of streets, <br /> � , 1 • � indicate location and width o: <br /> ;•:( _ • ' �. • alleys, locate proposed a,^.d all , <br /> � _. ,� existing buildiags, show distances <br /> • • �, � � to property lines, show distances <br /> � ! ' between buildi.:gs. <br /> ' .._ � ` Lot size X <br /> � Lot area Sq. Ft. <br /> � �" ' Size of Bldg. <br /> ` ' " Sq. Ft. <br /> ' . �� � ' Number of Stories <br /> . ._ <br /> :.• _ • Basement <br /> •� — <br /> j Signed By <br /> � For <br /> . . Owner hone � <br /> , DO :70: [t:22TE 9=LOI'7 THIS LI:IE-FOR CITY USc' Oi7L'L <br /> Date Seceived ��Q��'S" ' <br /> i <br /> U�e 2one <br /> ' I4an C;�eck ;iur„ber • ' <br /> Fire 2onc - <br /> Valuation /S�� �� Occuoancy Group <br /> Peznit Fee /5 , �� • <br /> Type of Constructian <br /> Plan Check Fee Occupant Load <br /> . : Total Fee Due � S, � Sprinklers Required • <br /> . Date Issued .�i/�/� �s__ ' • ' . <br /> —c. . �.• <br />