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-- . ! D02LDING PERMIT APPLSc.1TION • . :' , O� <� ,5..? -
<br /> ' ., ,� ' � , • �pplicant Ta Complete This ?orm ��Q 'd / �
<br /> � � s�/��'l�>>�
<br /> , • 2! more than one building ie ta be contructed, submit a separate permit applica-
<br /> : tioa for each huildinq. �1 separate permit will be issued for each buildinq.
<br /> . � � Oraer _fjOBG�,r /�, vC��F Dailding Address �i/�D �o/�NIC��C'//,� L
<br /> . � : ���_ �9a7 ����3�0 �t �c�-�� B��k � .
<br /> City E=U�?;G/'T Phone.i.ss `���� Subdivision (Plat) (�r.i:c Nu�?ST— �
<br /> _ ' • 1iChltect/Enqineer � L 7V/SIC,U � �
<br /> . :,, ' :;.I '
<br /> - =y �itY Phone Netes t Hounds (Unplatted)
<br /> . ,;, Coatractor ' Sec. rJ� a � R e 5 t, CJ,/{'�,
<br /> �•__ 4
<br /> . ' ` lddress • • . '
<br /> {'� �ty Phone Belldinq Jse .�iNGLE/-AMiG)' UG�C2U+��-.�. ':.
<br /> r} State.License N�L�n6er Deecribe Work to Be Done ��CMc:JT' . ''' .
<br /> � ; ,i Lzpfration Dat� � �UUNPRTID�I ,;lNOC)Z E,Ylti/N;; �?J,DG , `
<br /> �\ : �" , . SICETCFi PLOT PLAN SEL019' • /�e-/1 00� n C N 1� - .
<br /> ' . " i . � •
<br /> : : � : aueY . . . • S:,vci.:- r=nM�c� .
<br /> IIae of Huildinq D��t� �iN�
<br /> ♦ : � - . ' � • � ❑New
<br /> .� • t ' " s_— ` : ��(• . � _ . . . . :, ❑ A3dit_ion ��.;:a;•:i Ran,�uel
<br /> ' � ' � • • Valnation of. Coc.s:ructior. 5 '�>`C��� ��
<br /> � . . .
<br /> ��� ' � � � � " � PLOT PLAN REQUIREb1EN'PS
<br /> ., . . . . .. . . . • � - E �
<br /> � , � � . .
<br /> • �' .; � � • ' IaBicate lot size, name of streets,
<br /> � , j � . ' � ' •indicste location and u�idth of
<br /> . ,.. O ' ' - ' alleys, locate nr000seri and all .
<br /> _ '. ,�' , � - _ ._ � , . I . . lxisting buildinqs, shota distances
<br /> , to pzoperty lines, show distances
<br /> ` ; � � ' betxeen buildings.
<br /> � . , ��I . . Lot size x .
<br /> :- �
<br /> " E,, �N • Lot azea Sq. Ft.
<br /> �j ^• ' ' ' Size oE B1�- /n.2 .Z Sq. Ft.
<br /> . '.: . i� .
<br /> � • Number of Stories
<br /> :.. Basemeat
<br /> � =' . �� Signed By '�t�N
<br /> ' '� d��� G//D LoMMC�2ci9�. . s--
<br /> { 3�c's; •%j"sirzX ' F°r
<br /> �{ J. ° . � C2o55 S�:LrIoN. � Owner Phone �.fi-�X'/S!
<br /> t ; .:��� a,=. FouNn�ar�o�
<br /> e q: �
<br /> � DO NOT QZIT� H=LO[•7 THIj LI:]E-F07 CTTY i]Sz Oi7LY
<br /> ' � .
<br /> - •. Date �eceived �. D::e Zone ._
<br /> ' Plan Check :7ur„Ser ' Fire 2onc '
<br /> Valnation � (��Q. �U � '
<br /> Occuoancy Grou� ,
<br /> Pernit Fee �f� , ��= '
<br /> , , 'lype of Constructian
<br /> .' Plan Check Fee Occupant Load
<br /> . . : Sotal Fee Due I `U -� �p Sprinklers Required � .
<br /> • Date Issued _ � Z� � • .
<br /> • . . . :, ..K' . �,�,.,.� '���-� r:li,lZ�
<br /> • � � • � .
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