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_ � ! , ' . . ' � ' DOZLO�'NG PERMZT APPLZCATION . . . ' :•� ' � , , •'.•�
<br /> �.�,;i�;-�:�•..-� ' ��
<br /> t , � �plicaut To Complete This :orm ; , � .
<br /> � � , , • ;/.'/„ ;' 7
<br /> ' , , •' 2i more than one buildinq ie t:o be contructed, submit a separate permit applica-
<br /> ' ., tlon for eac buildinq A separate permit will be issued for each buildinq
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<br /> � , � �u t-�-'� ` � e'� Huilding Address �'"� 2-�� b� ., .
<br /> . , ` ,
<br /> . � � ,, / /I .
<br /> . ; iddress � �-�C�'�-��'- _ 1�ot� Block � -
<br /> , � Ci � Phone � 3ub �v#sion (P1 t) •
<br /> �� • � , c r-d
<br /> • lrchitect/Enqineer � . .
<br /> . 'ti+�� . '.`c'j City • one lletes i Bounds (U platted) ' . '
<br /> - . . ._ � � � _
<br /> ;,• Camtractor � ' �,c,�-E �� ,�� • g4� -
<br /> ..•, . � -�
<br /> _ .. .;., ..�• lddress Z " y/,�-.�' , � . ' ' t .
<br /> . .i - . �
<br /> �; Ci �i� �9�hone�� enildin Use � " � ` �' �
<br /> 4 ti.'�.N;:.:
<br /> , �.`y� � State.License N�nber �"7�•�dZ— J-i/I,� De ibe Work to Be D ne � , �'' � �
<br /> . . , • . / v
<br /> . : '.I. ttpization Dat� ' n� •-� :.
<br /> :' '� � i SICETCft PLOT PLAN BEIAW. � •. �-Q L 'l� �' _
<br /> - • •': _} ' .: . , . . . . � IIsa of Building � *
<br /> � 9
<br /> �._� j � , • ' � ; _ . •DNew ❑ Addition � Repair/Remofiel
<br /> � . „ ;.{' - . . . . � . � � i,- c�, • .
<br /> { . ' ' . • • , + • - �Paluation of Construction $ ��¢Ti• " . •
<br /> � • . . . .. . .
<br /> •,,,« .. r:. ' . . . .• PLOT PLl\N REQUIREt�1ENTS - �
<br /> ..► • . . � � . . . ;i .
<br /> - : :.�.. - . . .
<br /> ' � ��. � • , • . ' • ' •. •. • ' Indieate lot size, name of streets, �
<br /> , • , •' . • - • ' •indicate location and width of
<br /> • ' .�� ' � : ti� � ' ' _ � alleys, locate pr000sed and all �
<br /> '' •` ' • - � ' � lxisting buildinas, shoiv distances
<br /> _ . 3 � ' -•• • '-•'! . : •- ..4'� . . • . to propertp lines, show distznces
<br /> �. ; : ' � . ' • : bettaeen buildings. . �
<br /> : . • _ .
<br /> _ .�.. '., ' � � ' � � • . ' �ZAt 5�20 X � . .
<br /> .•i- � . . � . • � bot area Sq. Ft.
<br /> : �; = � • . . Size of Bldg. Sq. Ft.
<br /> '� . . • . �. Number of Stories i
<br /> �; • � • • . . gasement
<br /> �r.. : . . � . ' . . •- ' � �
<br /> �� ; . Signed By I
<br /> _ -�. ; � , . . . . . For . .
<br /> . � � � '� � ' ' � � � Owner Phone �
<br /> ', � ' � DO NOT S�^.tITL HSLOhI THIS LI:IE-cOR CITY USE OtIL'! `
<br /> —• —, Daie �eceived S��7S^ � Dce Zone . ;
<br /> ' Plan•CSeck :Iurber Fire Zone '
<br /> Valnation � ��Oq'L. �=�' Occuoancy Grou� '
<br /> : Pemit Fee /'7. �� ' Type of Construction ' .
<br /> . .' ' Plan Check Fee Occupant' Load • '
<br /> �
<br /> . , � ibtal Fee Due /7 9�' S�rinklers Required ' .
<br /> ' . Daic Issucd ' `�L�7� � • � � . ' . , . . . , , .
<br /> ' . .•• . � � � ' • . . . . . .
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