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__ ' � ' BUILDING PEAMZT APPLICATZON / �j� D� �: ..'� <br /> Applicant T. Complete This ^•orm � d <br /> 5 <br /> I! �ore than one building is to be contructed, submit a separate permit appl a'��" <br /> tion for each buildine. .1 separate permit will be issued for each building. <br /> . Owner ,�//-/ �� Building Address '"' Y/ z �•�„ , �4 � <br /> � , Address .JjL�OC�, �/,�/�c )'/ � � � Lot / Hlock �, <br /> City,�,F_�A ffl � Phone ��7 �`�=sLSubdivision (Plat) <br /> Architect/Engineer ' ��- /�GJI`�'/�L �j� / E i �7�7 .�� � <br /> i ---- i <br /> _ City � Phone Metes S Bounds (Unplatted) <br /> , Coniractor �� j� �k'g S � M il7'7�l� ���• _ 'hop. Rge <br /> _ Address��,�i Jl-SG c� . <br /> Cit �Y,y� Phone ' T ' <br /> y ]7�,' 5�1��%Building Use S'i�i�'�E f'/j',ri/i�� ' <br /> • / <br /> . ,j State License Number 2 � 3- o /— / 7'//j� Describe Work to Be Done / ' <br /> $xpiration oate Cj�- // - �S � _i�'�O .l� r_= __ <br /> '� - SRF.TCH PLOT PLAN BELOW' � �H. /T� S'lJl��r��., ' <br /> Ose nf Building <br /> i • <br /> _� ' 0 New ❑ Addition �"Repair/Remodel <br /> , , ' Valuation of Construction $ � 7 . z�, ���(� <br /> . <br /> �r.- � - ' •� PIAT PLAN REQUIRE6IENTS <br /> w � � , � � • Indicate lot size, name of streets, <br /> indicatc 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 x <br /> � •� Lot area Sq. Ft. � <br /> � ,. � • Size of Bldg. Sq. Ft. <br /> Number of Stories <br /> � . Basement <br /> � . . Signed By �_` / ./ C�Lf_�-�_v,. ��%j � <br /> ��— <br /> For <br /> Owner Phone <br /> DO NOT i•i.^IY� �'ciCF; .HIS LZNE-FOii CITY USE Oi7LY <br /> � � � �� �� . . <br /> Date ^eceived /�, - ) / Uee 2one <br /> Plan C::ecr: :Jc;ccr Fire 2one ' <br /> Valuatio❑ Occuaancy Group <br /> Pexr.iit Fee 7�, (�C� Type of Construction <br /> Plan Check Fec Occupant Load <br /> Total Fee Due Sprinklers Required <br /> Datc Issued � � <br />