|
, . . . . � M1 . \ . . . .. ._. . �
<br />..' � ' " ' � ' � EUTLDIt7G PLRMTT �iPPLTCl.T'LON � , / , �, � vf
<br />_ ' •• Z. • � • . �lpplicanl• To Complcte ���/� �'
<br />Tlii . : orm . , . ,• • i
<br />.. . ; . . : ,��s.��;s . . .
<br />,�,•' xi'pore Ehan one buildinq is to be contrvcted, submit n separate rerm t applica- ,
<br />.: Ci.:a for eaeh tuildin�. �1 separate permiL- will be issued for each bu.ilding.
<br />. � � (hm•_r �AF��`7 ��d`�I�IG� . lidinq Address to� L%� ��CTW��0.,r�! :
<br />. ` • . � Mtiress �r'%7 ��l- tf3)Yil.4 � Lo� �c �r� u�'' oi `�Slock � a'
<br />•' City �-v• Yhor.e f3Si�3ZJ�,�(,� 5ubc',i.'vi_,i�'on (P1aL1 ��Q�y�v,�f�� •
<br />�
<br />_ ` • 14schitcct/F.ngincer ��' � � ^ � � �
<br />_ ' i � . �_i Cfty • Phone � Idetes C 3ound� (UnplaLted) ' j
<br />:, ; ,^,ontr�ct.ar � � ' Sec._ _ ^awp. Rgc :
<br />_ ..� . . --
<br />�. %.. t,Ldresa ' • . ,
<br />. 'J: City Pl�o�ie Building Use _�� �U ' '';y_� �
<br />.�; ,:.. —
<br />� �'��--£tzte License Nc.�ber
<br />: . - Expiratzon Dat2 _
<br />' � • SRSTCH PliUT PL.1I SELO!+1'
<br />- ';�.•i .' � 9�oi,_��,.: ,.� �_ ..
<br />. :� -�- aa - -,--_r_�ti I..-.. :
<br />�:.. ��.�.
<br />u . ,n n , .
<br />K
<br />Describe Work to Be Done � l 11t- L°�F
<br />_ � s� ^� � GiiYY� , �'1 a �`� i� .
<br />�.
<br />���`���Yot�m . _ _ , -
<br />� IIse of Buildi.ny �_ �
<br />� - �� � C�New � h�dit-ion ❑ Repair/Reno::e].
<br />� Ci s
<br />_ Valuation of Construction S 2� ,', _ �
<br />� u���".�f���
<br />i
<br />�. (l� �'i i _ '
<br />�'• I ��- ',I.
<br />-•� �:.
<br />i� '�
<br />� :� _
<br />_. �'
<br />r-i.om PL7�N P.EQUTE2EtL.\TS ; -�
<br />�,.
<br />Yk;n_catc lct siz.c, nanc of treets�,
<br />•i.ndicaLe locat•ion an� widtnJof �_
<br />a21e}•s, locate oroposed ar.d all �
<br />Exi.si:zng b:ii].cings, shcw cistances
<br />to property lines, show distanees
<br />between Suildings. .
<br />� ' I�ot size ti_ '
<br />• . Lot arca Sq. F't_
<br />' I� � . Size of Bldct• •��{^�� Sa. Ft.
<br />� t7umber of Stories
<br />_ ____.. c�v�a
<br />' Aasement
<br />Sic�ned By .�./<, / ��f4__/�Ti
<br />� I- - -
<br />� 1?or ' u o4 � O`'- Z.Y'cJ
<br />• . O:.nes Phone (p'�«-� S (�
<br />� DO NOT Sti:t?'T'S 9�:Ai'7 T!]2� L1:2E-POii CITY i]SE O:IL'I � _,_
<br />DaCc T�ceived �+_! � '� Uce Zone �
<br />Plan C:uck _:ur.ber i' ��: " '' ��'';" � Fire Zor.o ? .
<br />Yalvation � `�-�d' � � Occunancy Group '1,
<br />O� ;
<br />Pcmit Fce 2•�Sf• _, ' �-Typc oi Constructicn �-N ^.
<br />. '— � •
<br />Plan Check [ce I�I •� r Uccupant z.oad �
<br />, ; Sbial Pcc puc
<br />nl�� a�s��a
<br />O
<br />¢z• r�
<br />Spziu3:].crs Rr�l��"�c�F �-pt'TT � .
<br />' r�PPROVGD �O.R•�BU!LDING PERMIT
<br />•, i_O�. ' i "��_8y. F � , .
<br />Date �-�-:-.
<br />. , .
<br />0
<br />
|