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. . . . , . ` . ' . . . . ._.,_—' . . .o' '—
<br /> , � ' ' . ,. . � • � � FiUILDING PE[3HL'P Ri,�pLYCATI0:1 . , ... � �•C',.� `' -'' ;'
<br /> - ' •' � ' , , • • Applicanl• To Completc •rhis :urm � ' /��� J_5 '• '�:S ,
<br /> .. . ; . : . . �'/��s';.
<br /> , • � 24taore than one UuilJin is to be contructed, submit a e aratc
<br /> 4 s p pernit applic�-
<br /> . Lion fofi . buildin. �l �eparate permit aill bc issucd for each bu '
<br /> � ' Qur_r-1 - � .��9� f
<br /> • � ��r � � '��l_`��_ Buildinq Address ����Z�����.1`�;
<br /> • , Plidre.:te <l ` [> � �
<br /> � r' �'"�'�"" �.oi Elock
<br /> . '�" �,d
<br /> , City ��/t-e�.�� Phone -� U�z�ubdibision (Plat) ^ .
<br /> ' - &xchitect/Enginecr • • • .
<br /> • �� � `'� City • Phone Ffetes & Bour.ds (Unplatted)
<br /> _ ._� �_
<br /> �_-- ._��_ ..
<br /> _ :,': Contzactor ' Sec. Twp. Rge �
<br /> _ ..� .
<br /> �.. i. . AdBress ' . . . •
<br /> . �� City Phone Huilding Use • '
<br /> . ' ''"„ -;i' ,
<br /> . • ti State.License L1c�aa' er �_ i)escribe Work to He 6one .Q �A r�"
<br /> e
<br /> • • 'I Ezpiration Dat� ' (' �i. -� ' y Il.
<br /> . r-� ,Z'
<br /> �� ' • • S�ETCfT PLOT PL�.?I BELOT4� • -
<br /> '. ' • • + . . e _ • .
<br /> : _� " • . � : Use of IIuilding
<br /> a� � ' ' . � . .,. � �New ❑ Tuidition ;,�Repair/Remo�el
<br /> . . , �' � • �` �
<br /> � j� " • . • • 031uation o£ Constructzon S ,.,L° 5 v '—
<br /> � 'e . . . . .. .. . � � I . � .
<br /> .,�. . - � .. � SLJT PLFll1 ?.LQUI�2ESLUT$ .
<br /> -e, • . . . .. ,._ � . . . . .
<br /> < . . . . . . . . � -
<br /> . ; � ' � ' - , . ' . ' � ' ' Ii�dicate lot size, nane of streets,
<br /> � '� ' • ._ ' _ . ' � ' ' •indicate location ar.c width of �
<br /> . .. _ , allc,�s, locate �r000sed ar.d all
<br /> � ' '' . � . � ' • � ' • ev.i�ting buildi:gs, shc:v distancr.s
<br /> : � ' •.. ' •- '9 ' ' . • °= • . to property lines, show distances
<br /> ; : ' � q ' , - betWecn buildir.gs.
<br /> � _. . .
<br /> . . ' . _ .• . � - �. ,. . Lot size x . '
<br /> •.- � • . ' ' • . Zr�t area � Sq. FY..
<br /> � r. = . . � ' � � . Size oi Bldg. — Ea. Ft. .
<br /> � `� , • - Numbcr o� Stories
<br /> . • ' :: . j � . . . - . � , . . . . Basement � � . .
<br /> n:. . . � � ' � i-
<br /> o ,° ' . Signed IIy /! .e•«.< . �r�
<br /> • �- , ' . . . � ' )(For
<br /> , - � � • . Qwner Phone
<br /> .. ' . . . ' UO :IOT S�:2T_TS *3=LOS:' T}iI5 LIVr'.-?OR CITY USE OtIL'L ' . .
<br /> Datc ��ccived 1 ? Uce Zone • �
<br /> ' Rlan Chec;: :Iur..Ser ' ' Fire Zvnc ' �
<br /> ,
<br /> Valua:ion '1.`_.: J �"l Occunancy Grou�
<br /> Pemi� F'ce � � i �v :ype �f Co�,struction
<br /> Plan Cl�eck Pce — Occupant Load •
<br /> . : Total Pec Due `�� vG _ Sprinl:lcr� Required ' _ .
<br /> Datc Issucd � � �. ' _
<br /> , . , Z[ r . . • . .
<br /> . ' _ . , ' � , .
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