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_ ' :. ! ' . ' ' ' DOILDING PERMZT APPLICATION . . . .. : ,,����� .
<br /> 1 • �pplicant To Complete This ?orm � '
<br /> .. , � • , 1j�
<br /> , � Ii oore than ane buildinq is to be contructed, submit a separate pezmit appli�a-�r
<br /> ' ., tioa for each buildinq. 11 separate permit will be issued for each building.
<br /> • � , � �� _�i O��l � �,��� 8nildinq Address � � � �^�SS ..
<br /> ' , � iddress �;; �� L?vp ress Lot<��.? Block 7 _ �
<br /> / �
<br /> '�_�. ., '� City t� Phone.3�ii-%y�/7 Subdivision (Plat1 /%'�'�i � ,%� ? i' �
<br /> i .
<br /> � ,
<br /> • ' � kehitect/Engineer � :�" ,-/�; Ir� � .
<br /> • '��� '`_'� City • Phone Metes i Hounds (Unplatted) ' '
<br /> . -� . • i
<br /> - . �. :�' Caltractor ,�/,'��C R;//O � ��lr� sec. St�rp. ' ttqe
<br /> -.. _: ,.�. iaa=�SS ,3.,2/9 �,��� � � . . . - .
<br /> � ' City �d�NP� Phone,���:—�5 3002. Buildinq Use . "'-':.-��1-j
<br /> •.•••.•.�� :. �''� . . , `l`•�f•Y •
<br /> ' State Liaense Nianber • � Describe Work to Be Done v' "'
<br /> . L. _
<br /> : .;y� � �����.
<br /> : � ';1. Lspiration Date • • ''
<br /> 1: 'ti+. - % SICETCH PLOT PLAN BELOfQ� • � � _ ..
<br /> .• .. : j , , .: ' ' . . . � IIsa of Buildinq �
<br /> ' 4
<br /> a � • � � , .; , , , •�New O Addition �ReFair/Remofiel
<br /> . . . ,;' . , � ' - �.' , .
<br /> . " { � ' '. . • - . � •' • •Valnation of Construction ;� �� . •
<br /> r.� � • � � . . . . . � � . BIAT PLAN REQUIBF.�fENTS •
<br /> -.. • - � ' ' . . '
<br /> � . • , . . • .
<br /> � ' 'i • • • • - ' Iadicate lot size, name of streets, �
<br /> �� ' ' • • �' " ' ' •indicate location and width of
<br /> • '' a�l. � _ i: � ' . • illeys, locate pronosed and all � �
<br /> • �`i ' • - - • existing buildiags, show distances
<br /> : 1l ' � •.:^+"'" '-�� ' . ' '.�'� : . . to property lines. show distances
<br /> � ; 1 • � . " . • : betWeen buildings. . �
<br /> � ' • • -- • - •
<br /> . ..' . ' • � • ' . • . . , ' I/ot size x
<br /> ..i: � , ' . • � Lot area Sq. Ft.
<br /> : �; = � �• , . Size of Bidg. Sq. Ft.
<br /> 't . , � . , �. liumber of Stories •
<br /> • � :: ' • Basement ,
<br /> ���� � � ' � . . ' � �� � Signed By � , „u'� 'y.° ���J� �'
<br /> . � � � � , , . . . . , . /' � � `� � ,
<br /> . : . , : . . . . For i .
<br /> . . ' '. ' ' Owner Phone
<br /> � , � ' • DO NOT S2:tIT� H?L'�tl THIS LZ:]E-FOR CITY USE OiIL'i � .
<br /> --• — Date Seceived � Dte Zone
<br /> ' Plan•CSeck :Iurber ' � Fire Zonc '
<br /> Valnation � � Occuoancy Grou�
<br /> . Pemit' Fee ' Type of Construction : .
<br /> . . ' Plan Check Fee Occupant' 7.oad •
<br /> . , � Sbtal Fee Due ' Sprinklcrs Required ' .
<br /> ' , . • Date Issued� ' . . ' , • , , .
<br /> � . ''' . , . . . , � . . •.�:. , ' , � . . . . .' .:Y.
<br /> • • . ': , . . ; . • . •• • • . . ;' , _�
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