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-• �, � DQILDING PERMIT APPLICATION � � ' �=
<br /> � . . Applicant To Complete This ?orm �� �- ) �.i�
<br /> � - I! more than one buildinq is to be contructed, submit a se ax•ate / /(�
<br /> . tion fo each buildinq. A se arate P Permit applica-
<br /> � p permit will be issued for each buildinq. /
<br /> � /.,
<br /> . ' ��_ pp~�� 1 �• •�°����' Huildinq Address ��.�.� .t;�..,�^ , " ' �"�`'ti
<br /> , � . llddress OD2� r..-.�-u'il,�t�sE,^yl � ' Lot �S �r Block
<br /> . City �11 �.a'f,:'��' phone ,��s,�-,� �, '��=���+ g�ivision (Plat) '�.;,- %P.'@@�.� ;
<br /> . 7lrchitect/Enqineer � �`,:^�� `r" ��� �-�<i�;t;.;??^- "�- �
<br /> :..I . v� �-� ti.Y' �,_ .
<br /> a 4,
<br /> - �j �itY n� Phone Metes 6 Bounds ;L�nplatted)
<br /> , Contractor i vl;�,..
<br /> .. . Sec. TV��, gQe �
<br /> _ ]Iddress .
<br /> �. City Phone Building Use '
<br /> , ;
<br /> • ;; State License Number •' �"�`�'.� :
<br /> , . . _ . Describe Wo�•k to Be Done '�L.��'�t"V.�_!
<br /> . i �piration Dat� ' lr � h,\��� ' TC.';��:t' �n,�, .�' � ....�A�
<br /> :� � � � -�r /
<br /> . . . � SKETCH PLOT PL}1N gELO[J� • _
<br /> ' i . .
<br /> � � Ose of Building •
<br /> ', � • � . �New
<br /> ❑ Addition `�Repair/Remofiel
<br /> � • � _ � � Valuation of Construction $ - "
<br /> •
<br /> ,r•.- � . � . � . � . . PLOT PLAN REQUIREFIEP:I'S . .
<br /> : ..
<br /> ; � , Indicate lot size, name of streets,
<br /> . ; • . - �indicate location and width of
<br /> ;•'� � ' . alleys, locate pr000sed and all �
<br /> _ •� - existiny buildings, shoia distances
<br /> �� - to property lines, show distances
<br /> ; � . ' between buildings.
<br /> Lot size x
<br /> .• 1
<br /> Lot area Sq. Ft.
<br /> ��. '•• � ' Size of Bl g. S Ft.
<br /> ' Number of tories 4�
<br /> ,-.. � i • BasementQ �`';
<br /> • � , �-�- • Y� f ` ���,.f ... f .f ,f
<br /> Signed By � ��.: ,•`��.,,.r�� 3;s.. .,..
<br /> �
<br /> For
<br /> , Owner Phone
<br /> , DO :IOT �C:iIT� H�LO[d THIS LINE-POZ CITY USn^ Oi7L'f
<br /> Date S�ceived ��� / �' S ^ Uce Zone
<br /> P1an.C;�eck Yur:,ber Fire Zanc -
<br /> Valuation _�C�p , �6 •
<br /> Occuoancy Grou�
<br /> Pemit Fee 5 , �v '
<br /> Type of Construction
<br /> Plan Check Fee Occupant Load
<br /> , Total Fee Due � , r`� Spzinklers Required
<br /> Date Issued _ ��� � � � � ' • .
<br /> •
<br /> � . _
<br />
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