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/�a�7 <br />5�� � j •' <br />•' If more khan or.e uuildinq is to be contructed, submit a separata permit applica•� <br />� tion for each building. �1 separate permit will bc issued for each Euilding. <br />�� CnOe! � /J; ✓ � /�pl �..-��/ Buildinq Add:ess, �?s�� iTi�+,fi��%6's�,2� <br />� Lt�t�`� ti@ � � Block - <br />' , 3ddrees .-vj � =-vt;.r rm �-:�;� -- . . <br />City �,. _ Phone Subdivision (Plat) ,,,T �i • <br />, <br />' • Ltchitect/Enqineei- -- � �-i� �'ei�� — <br />� _.1 <br />- - "i <br />:' <br />, <br />il <br />.� <br />rt <br />• �t <br />.1: <br />. • .'t <br />City � Phone <br />Contzactor �g�j1ot � •C��t�c,�1. -- <br />]IdLress �� � � a o . � � <br />City C.�.,e\n�micf,.. Phone c��^ri,-i 4T <br />,,- . ." <br />SWte License Number - �! -! 7SS � <br />Lzpiratian Dat� J/, - c��f �- �� <br />� - . : ' ._� <br />� .� <br />_�,,.• <br />: <br />SIIETCH PLOT PLAN HELOW- • <br />Metes s Boends (Unplatted) <br />Sec. 7t+p. R4e _ <br />Hn3.ldinq Dse �7 � [� � • <br />�)� V��l.�. 4AVY11�i{�.y:la.elLA1y <br />, ....rr , - \�I <br />Describe Work to He Don� __ ` <br />C� i S w� i`.-�, r7Y_ �: • . <br />! �c� rn P <br />IIae of Building •�� ti.i � ��`��`-� �W . <br />v <br />�w [a ]lddition Q Repair�'Remofiel ' <br />. � 'Valuation of Construction S ' <br />. : . PIAT Pi.AN REQUZHEFIENTS . <br />-. . . "' Y <br />• <br />. <br />L 7i,SJ � ' '' <br />r.. - � i� � � J <br />� •�� <br />; - <br />-_ �� . <br />DO NO': <br />THSS <br />Date Ceceived �}-�q-{'7.�5 _ <br />Pian C;ieck :mr.,Ser '7 �— � � <br />Valuation _ <br />Yemit Fee <br />Plan Check Fee _ <br />, � Total Fee Due <br />Datc issued <br />Yadicate lot size, nane of streecs, <br />indicate location and width oP <br />alleys, locate pronosed and all <br />existing buildinqs, sho�a distances <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />Lot azea Sq. Ft. <br />Size of Bldq. ia r'ft Sa. Ft. <br />Number of Stories � <br />Hasement _,�. � <br />�\�' <br />y Signed Hy� - <br />Pcr \ � <br />pwnez —S Phone <br />z-POR CITY USE O2IL:! <br />Ace Zone <br />Fire 7�ne _ <br />Occuoancy Group __ <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />