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� <br />-=- -- - _ _ - - - - - --- - -- -- - -- - _ . _ _ . _ _ _ . „ � <br />f��- BUILDING PERMIT APPLTCATION / � � � '•�•� <br />�.� Applicant To Complete This ^orm � /�/���� <br />If more than one building is to be contructed, submit a separate permit applica- <br />tion for each huildi�g. �l sep:irate permit wi11 be issued for each building. <br />Owner ��l;q_ y �d(t �d c �' t' c�n/ Bui.lding Address �,: O� i /Y%rr r�� s-a n/ - <br />T <br />Address �/,j� ,5 3=d Gv�rf <br />City F� a � r� Phone ;.S ,� C�/�/.L <br />Architect/Engineer t�,�,,,.r, n.r el-r.--�- <br />City — _Phone ��— <br />Lot � Block <br />Subdivision (Plat) <br />i ../ / 1 <br />F�a�i !�� �1ntRV f/'�CJi /�'q� <br />Metes 5 Bounds (Unplatted) <br />Contractar .5,�,,.,p nr rrG,,:.� Sec. T�rp. Rge <br />Address <br />City _ _--- Phone <br />State License Number .2.Z.�-C/-/�}(ly <br />Expiration Date / � - / - 7.5� <br />SRETCA PLOT PLI�i1 BELO(Q <br />/)JR� <br />--' � � <br />Building Use �/r �� �..; �� � � r, � <br />Describe Work to Be Done � <br />/� ;? <br />/�.,:�p� .1" -,� .r.o, ;�, / ,r. <br />., <br />-� • <br />Ose of Building /� rt'. _ <br />�P]ew ❑ Addition ❑ Repair/Remoda.l <br />� r <br />. � <br />Valuation of Construction $� OJ�O.� � <br />. PLOT PI.AN REQUIREI�SENTS <br />Indicate lot size, name of streets, <br />indicate location and width of <br />� alleys, locate proposed and all <br />C existing buildings „show distances <br />� . to property lines, show distances <br />� between buildings. <br />Lot size � :' x !/O _ <br />Lot area �(tiLl Sq. Ft. <br />Si.z � of Bldg. �,j� Sq. Ft. <br />Number of Stories / <br />Basem�nt i <br />/�: <br />i <br />Signed By , -" <br />; � - ���: �-, :-��-� <br />For <br />Owner ��� �Phone '��S -;; u � Z <br />—� <br />a <br />DO NOT WRITE BtiLCSC! THIS LINE-FOR CITY USE O[7LY <br />Date ".ecei�:e� �- Z � il_e Zone �ZyS�ulal.idT-7al�n �� <br />Plan Che.c:c ^lur,ber �f�� 1 � Fire Zcne � 3 � _ <br />Valuation 15,Libb�•=-� <br />�--�t <br />Pemit Fee <br />Plan Checl: Fee <br />Total Fee Due <br />pate Zssued <br />��[�% �;f�-+",t�' 1 t -' ZZ— �. <br />Occuoancy Group _ <br />Type of Construction <br />OccuFant Load <br />Sprinklers Required <br />