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•' .' `� � ' ' ' ' EOZLDING PERMIT APPLICATZON � / ' ' � � T�.Z
<br /> ' • • t • • � � . . �pplicant To Complete This =orm • f ��� 'G� ' � `_�'y
<br /> ," � ,2//7�
<br /> � ;. • - , ' �f tare than one 6uildinq is to be contructed, submit a separate p�(f �p�lica- ,
<br /> ' . ., ; tioA for ch buildir.q. eparate ermit will bc issued for each building.
<br /> . � ' Mner �ChA� � � /�04lP.11f� /f/��f�nilding Address �S/DO (9-,CPN(A/DO� . = �
<br /> '` . i � �ddress �,10 Cr�P.✓lun oo� Lot Block ' •
<br /> �. �� Clty �,f��'� Phone ��-/9 3ubdivision (Plat) •
<br /> ' � ' b5=5 3 � •
<br /> " ' �rchiteet/Enqineer ' • . •
<br /> _ •ti�� .,..`9� City • Phone Metes i Hounds (Unplatted) ' _ '
<br /> . ;,' Coatract��r • . � . Sec. ittp. Rg�
<br /> .� . . .
<br /> t. ?. ..i• �ddress . '. • . .
<br /> �i, . City Phone Hnilding Use ' ' • •; ��
<br /> _'�.,.
<br /> ... 4j .�::' . . . " ' F'�"': ..
<br /> .. 'y � SLate,License Nianber • Describe Work to Be Done i.C.(� — ���� �
<br /> ;.' `� . '� � :.
<br /> � : � ;�. Lzpiration Dat�e _ ' �Do �1o�ar
<br /> �1: '" • . SICRTCH PLOT PLAN BELOW' . •. � • . . - .
<br /> , , ..� , . . ... , ' • - ... � • ,� • � . . .
<br /> IIse of Building
<br /> �. i � . ' ' � . • LINew � Addition ❑ Repair/RemoGel
<br /> . . �.i � ' • • . � , ' • �. . � ..
<br /> , j • ' , . , �.. . �Valnation of Construction $ � �
<br /> .
<br /> r. � . - . . � . . � ^ . . 87AT PLAN REQUI_REFIENTS J , _
<br /> ••• • • , - , � . . •
<br /> Indicate lot size, name of streets,
<br /> .� !.' � • ' � � • ' ' •indicate location and width of
<br /> . ,� I • . � i'. : '- _ _ • alleys, locate pr000sed and all �
<br /> . . •• �:'j . ' � ' • - ' ' existing buzldings, shoca distances
<br /> � i ?� • ..:^_`•'-"-•y • . - , °� : . . to property lines, show distznces .
<br /> : �' t • � , ' - : between buildings.
<br /> . . i . . . . . � - . . � . . , . .
<br /> � � ' � • � . � - � ' . .TAt S�ZO X . ..
<br /> t. ..i- • . , . ? � . Lot area Sq. Ft.
<br /> - ; r; : � � � � �• �, .� Size of Hld Sq. Ft.
<br /> �i •• . , " . , tiumber of Sto �' es •
<br /> :. �' . . , . Haseme
<br /> ::.. • . _
<br /> ,+ ,_ ....- � . Signed By �,.� ,- �GG
<br /> _ i � . . . . . � � � ,
<br /> , : For
<br /> , ' � '. ' Owner hone y- 9
<br /> . . ' ' .. . , ��5-9f�G�. �
<br /> - ' ' DO NOT Si:2IT� B�LO[�7 THIS LINE-FOR CZTY USE ONL'i ' ,
<br /> ��- — Date Seceiv�3 S ' S� � II�e Zone
<br /> ' Plan.Check :7urSer � � Fire 2onc '
<br /> Yalnation Occuoancy Group
<br /> � . Pemit Fee ���� �� � . Yype of Construction ' .
<br /> . ' ' Plan Check Fee ��O- �'� Oecupant Load .
<br /> , , � Sbtal Fee Due //0: � Sprinklcrs Required ' .
<br /> '.. ' . • CITY 0!= EVi_R�TT
<br /> ' � � Datc Issued� ' ��~L/�7s� ' • ' •EIPPRQVED''�QR f JIL '
<br /> • .. �. . . �' DIf�G, PLRI:�: f
<br /> .. , , . . . , . �. . , • . • '. Date: '�;'l l��gy '.�'� . • , .-
<br /> . , . . . , . . . • . . . ��
<br /> ��'i
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