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—�- -�- - -- - -- . . . BUILDING PERMIT APPLICATION� ,�v�I C��/�L� `�l%/YT��j�n <br /> � Applicant To Complete This ^orm Q/Z( ��_ �G�_ 7C� , �/ n L'�� <br /> X / <br /> Zf more than one building is to be ccn:ruc`ed, subnit a separate permit applica- <br /> �/tibn f�r each 6uilding. il separate permit will 6e issued fur each building. ///�i <br /> 7 Owner. RoQERr �I. I.EAF Buildinq �33ress _6/�� CoM'ME�PCiAL /7 <br /> Address GI/O COMMERCI�L Lot ID } �� slock �_ <br /> City �vfRFrr Phone 355-� �L� Subdivision (Plat) P,ueNuRST <br /> Architect/Engineer ��.1NER �IVISION A <br /> City Phone Metes s Hounds (Unplatted) <br /> Contractor OwNE2 Sec._;� 4Wp. eZ � Rge 5 E:�::'1. <br /> Address ' <br /> City Phone Building Use ��uG�E FAH/LY DWE�LIdJ�� <br /> State License Number Describe iGork to Be Done CoHv�srE RE'w�RE <br /> Expiration Date R$J.OGATE pI,4MB/�G� REOA�R S�0/UG� <br /> SRETCH rLOT rr.r+N neLow MooERN/2F /NtERie� �EOtAeFIiJiNDocJJ. <br /> R �-���� __ _ _ Ose of Building � <br /> �p�� �,�3� �New ❑ Addition � Repair/Remodel <br /> , _. <br /> ,lv`XL �G .R'f -� ' Valuation of Construction S � ;, �.'i�:�—' <br /> � �(-�..-.�'-�- - - � � � i <br /> �T'4'1 l PLOT PI.AN REQUIR&�IENTS <br /> ("�t� 1�•''ti � B�o PooN �+ . , ( <br /> r , !�ac�i , . <br /> I r Indicate lot size, nane of streets, <br /> ,/ -� �'�� � i indicate location and width oe <br /> y� - "°�" en,H I �i n alleys, locate nroposed and all <br /> x M• r.rtcw•�. <br /> of , ,___ _� , � existing buildings, shao diatances <br /> —� a '+ � ' � � to property lines, show distances <br /> - ----�� a • between buildings. <br /> ww.nq� � <br /> � ��vi��C. ��"'T'�3 � '�. �' Lot size � _x <br /> . ' �ooM ��� i'oo�� � 5eX3� — <br /> , ,Y Lot area Sq. Ft. <br /> . ; � i � Size oE Bldg. (,1�, S?. Ft. <br /> Number of Stories � ( <br /> _•.. I r--+___ ,_ � � Base�ent � � <br /> ', - �_ roA�r _ I t � i <br /> � Signed By � „ d " <br /> G � �o ,=o>IF�cR�'a! For � <br /> ( <br /> —�--- - � - - � - - Owner Phone �. 4.-��.� - I <br /> ' <br /> DO NOT WRITG BELJI9 TFiIS LINE-FOR CITY USE Oi7LY I <br /> Date Sace:ca3 ��- i'-' :�=/ --U_e �one t <br /> i <br /> Plzn Cltec% `lumber Fire 3one ' � <br /> Valuation Occuoancy Group <br /> Pemit Pee Type of Construction � i� <br /> � f <br /> Plan Checl: Fee Occupant Load ' <br /> Tetal Fee :,ue _ Sprinklers Required y <br /> Date Issucd ' _ � , � <br /> �. <br /> � ; <br />