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, � � ✓� � <br /> � 3�3/ <br /> BUILDING P��IT1eteLThislForm �� <br /> �; Applicant To Comp <br /> . ; <br /> � A separate permit will be issucd Eor each build- <br /> If more than one buildinq is to be constructed, submit a separate permit ap- . <br /> plication for each builaing. <br /> ing. � � � :;/7� puilding Address �� . , <br /> Owner '�y �A� � �_ Se_,���G��Q�G�.lJ <br /> J (r �1 ,� 7�-�-C� Lot .��L _ IIiK. <br /> Address : _ -- <br /> Rqe. <br /> City�,�,�1 <br /> � Phone�D �. 3 y� T'''p� <br /> Subdivision (Plat) <br /> Architect � <br /> City <br /> Phone_�� Metes & Dounds (Unplatted)_�� <br /> Contiactor E <br /> Address . ---��rr C- _ <br /> Phone__� Buildin9 Use <br /> City � <br /> � � Describe 47orY, to IIe Done�_—�� <br /> - � SCate License Number <br /> gapiration Date � � <br /> Use of IIuilding <br /> ._New �dition Repair/Fenodel C� <br /> • Valuation of Construction S�,��� <br /> � � � PLOT PL7+.*I <br /> � Indicate lot size, name �f streets, <br /> ' indi.catc location aosea'and all <br /> ' axleys, locate proP <br /> existing Uuildings, show distances <br /> to property lines, show distances <br /> beto�een buildings. <br /> � <br /> . � LOC siZe x S.F. ; � <br /> � Lot area g,g, ` I <br /> • � Size of llldg. , <br /> Number of Siories <br /> IIasement <br /> Use Zone � ��. <br /> Signed Dy � � /��� I j <br /> For IOwner <br /> DO NOT WRITE IIGLOSJ TIIIS LIN�-FOR CITY US� ONLY ( <br /> Fire Zone <br /> pate Iteccivea 3--�Z—� � e of construction • <br /> _� TyP <br /> plan Check Number � �--- pccupancy Group <br /> valuation � - <br /> �'O Occupant Load <br /> .Permit Pce `� • <br /> Plan Check Fee ( O <br /> Sprinklcrs Required <br /> � Total kce Due - . <br /> � PeLmit Number / <br /> '7� t � -� � . . <br /> pate zssued�— <br /> APPROV[D FOR QUILDING PGRMIT <br /> n.,i� - <br /> -c• - _-.• <br /> �t'`Z' S -.-i 7 t7i t _ �'L L� � <br />