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' Applicant To Complcte T;�is Porrt, ' � r � �� / <br /> / �� <br /> If more than one buildinq is to be c�ntructed, submit a separate permit applica-/ „l !//� . <br /> tion for each buildinq. A separ�te pe=r.it will be issued for each 6uilding. �o7j <br /> owner �1 !G� Cu n�r� i tii s Huildin,• nddress �n;ZG ��m me�r�i�j, <br /> Addre�s �O u2C C.J/1?ME��CRL $iT Lot y•/C -)/•IL•, .'i Dl ck OCS 7 F `'C <br /> City �v6�?L� Phone 3S3—I�I.�S Subdivision (P1at) <br /> Architect/Engineer j��]3 �i/�� � - f'tLfllS � DI� /T <br /> City `=YL�RE�—Phone j�$;3- �42'� Metes 6 IIounds ( nplatted) <br /> Contractor �y J� �^ S 'NL Sec. i Rge <br /> Address ,� n �S�Ox � / � _ " <br /> City � ��'� ! Phone ,�,j� •��/c� 7 Bui ding L'se _C/ C�� � <br /> State License Number 00' De cribe Work to Be ne ' <br /> / T L- � ��� �/�C� <br /> F:xpiration Date %� C "I Jc � <br /> ' cc�N� R�TE' I3 c�m�l �- � <br /> SRETCP. PLOT PLAf] BELOW _ , " l�F� n7I h(� <br /> Use of 9u' ding �i�J2�� � <br /> New ❑ Addition ❑ Repair/Remodcl � <br /> lp � �'4 nq1 En�C/-FL ST, ' Val tion o: ConsL-ruction $ I <br /> i <br /> -- - - ------ - - --- --- .._ ri.oT rt;.:a r�eQuixsr��Ts : i <br /> � <br /> . � <br /> Indicate lot sizc, nane of strcets, � <br /> �. __� indic?te location and width of <br /> {�OUSf� ., allcy• , locatc propcsed and all i <br /> J i y� exiating buildings, s`.o•d distances <br /> n , i � �� - � to proper.y lines, shcw di�tances <br /> ,� betwecn buildinys. <br /> � � z$� y � �'p Lot size _/z rj x /2G ,� <br /> ' j ____ � Lot area /.7.OG'!? Sq. Ft. �1 <br /> i r ��� Size of 91dg. ��_ Sq. Ft. �i <br /> �. . ' GA���•'�a � ___ Numb�_: o: Stories � (+N��- !i <br /> , . � 3� Basemer.` N�- ! <br /> � i <br /> � � � ' Signed IIy ;; <br /> . <br /> ---__.. .. . _ . ._.._.�. .- �- - ----�--- �� <br /> �1�� roz � c'2 L"v/us' � N� ' <br /> O�.�cr Phor.e '_�"_""7� } . <br /> � <br /> DO NOT WRITG B�'LOIJ THIS T.I;IF-FOR CITY CSE O;ILY <br /> Date .-.��e_vc� �'�-[ � - 7� U�e "one *=�-Z� 'froM . H�4H Y�'�' I ,�' <br /> ^ D�JC� <br /> Plan CSec't `7unbcr Fire Zone #' $. ' • <br /> Valuation Occunancy Group _ _ � <br /> I' <br /> Pem it Fce Type of Constructi[n � �� <br /> Plan Check Fee Occupant Load �, <br /> Total Fce Due Y Sprinklcrs ^equired f <br /> i <br /> Date Issuc3 � -� �� `���� ��� �� <br /> n AP�r �� � - : , . ._�..,. .,,- i <br /> � � �z-i <br /> . , . �G���� e-7¢ ��,� , '�r'`�56--��'' ! <br /> NC� �Tio.y �F r�;^n'�� To '�,r. U.-ri�..iz.t� -�o�_ "A��?cv-Y b�tS� r,l��• . <br />