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BUILDING PERMIT APPLICATZON - , �J / / �•j <br /> Applicant To Complete This 9orm /���/,�- <br /> If. t�ore than one building is to be contructed, submit a separate permit applica- <br /> Ylon for ea.ch h,�ilding. A separate permit wi11 be issued for each building. � <br /> Owner ��� LC�a� �C�C��o_ � Buildinq Address ���� � ��/�"cYtl�?l.C� <br /> Address ��,�� �iC'� i x ^rn�uA � Lot�3�Q a7�N�:�( Block nl �" �-� <br /> City 4Q, � Phone Y, - ' � Subdivision (Plat) u�r2_ � i�..�$ ��01 g <br /> Architect/Engineer <br /> City ^ Phone — Metes b Bounds (Unplatte3) <br /> (� 0 ,, /� <br /> Contractor �SQiLQ'i�" c�X�1LcQRh�i �I1�C. Sec.-- - - 1Wp. Rge - <br /> Address �� � 4Q'1 0 v� �� <br /> City _� �I � �_ Phone '� � Building Use �a.C,rn�G , l <br /> State License Number ��-��7-C�- � � ��� Describe Work to Se Done <br /> I G ��(� <br /> Expiration Date k+' �-�1� L �� � � �N � � '� y"��� <br /> . -, i <br /> SKETCFI PLOT PLAN BELOW , � <br /> Use of Building _ <br /> . ❑New ❑ Addition L�3�air/Remodel <br /> n 'I O � ' <br /> � � ' Val.uation of Construction $ ��•i5'7: . <br /> � � • . PIAT PLF1N REQUIREI•IENTS <br /> . Indicate lot size, name of streets, <br /> indicate location and width of <br /> alleys, locate proposed and all <br /> � existing buildings„show distances <br /> � � to property lines, show distances <br /> ' between buildings. <br /> Lot size a <br /> • Lot area Sq. Ft. � � <br /> � � Size of Bldg. Sa. Ft. <br /> Num6er of Stocies � <br /> t <br /> �. easemeyt ; <br /> Signed By � �i1���.� � � <br /> For � <br /> Owner Phone` ; <br /> i <br /> DO NOT [92ITG 6ELOl•J THIS LINE-FOR CITY USE Of7LY I <br /> � t <br /> Date .^._cei�efl _ U_r_ Zone ! <br /> Plan Check Vunber Fire Zon� � � <br /> Valuation Ib ��( /S�rOU Occuoancy Group ' <br /> Perc�it Fee Type of Construction � <br /> Plan Chec4: Fee Occupant Load j <br /> Total Fee Due Sprinklers Zequired <br /> CITI' OF E`��;;�TT <br /> Datc �ssued AP°RO`J�D FUi� 6UILGI��G PERPAIT <br /> � <br /> Date — i=;+_ __ - — <br />