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. , _ , � . . ,: . - : � � ��:�� � . ._.�
<br />- , ,;� � , • 80IL'UINC PERNIT APPLICATIO�I �, ' ' • t• 1`.
<br />.. . . . , � ]I�plicant To Complete This :orm � '' � � f .
<br />� ••� .2! nore than onc buildiny is to bc contructed., submit a c ar.atc ' '�/y��
<br />•� tion for eacl� buildin�. .1 e azate ' P pernit applic�-
<br />, � P� permit will bc issucd for each building.
<br />• ' �6mer � ,�� � ,� •
<br />� . _ .: � .-,. �. � It . _ . , � ,
<br />Suildinq Address I �i-�r ���<�!'��- j�� :
<br />,• .
<br />_ ' . pddre�s I`1�5 Yr,i pccc,rlt, -,.,
<br />_ �t -'.— Hlock
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<br />' City E''; = r c .',-t' � • Phone .5� • -�zj �, Sub3ivision (Plat) ; r - . =, � . . .
<br />' • Erchitect/Engineer ::.a.� F �
<br />�_ `:i City Phone Hetes 8 IIounds (Unplatted)
<br />_ .-;�: CAntractor Sec. � ..
<br />. • ,, � . , 2t�''-.._ R4�
<br />� .�.3ress , •
<br />.� i� -�tY Phone -iiuilding Usc �
<br />� .4" :.';'.
<br />yi � Strte License NL.-iber Describe Work to IIe Dor.e
<br />. _ ,� ,
<br />' • ------�_
<br />; �l i�piration Dat� f�): , , . I.� �.� . . .
<br />r� ,�
<br />�� � �~ • SP.ETCIi PLOT PL;�I BELOW'
<br />. � • . ' -
<br />. ;..1 . . • _ . � Dse oL yuilding . . •
<br />- . . � • • • _ . ; ' nhecr ❑ �ddi.ti on Q P.epair/�eno:3e1
<br />� ~ ' - ' • • � • Valuation o� Con�truction $ Se�a� " '
<br />... . . . .. . .
<br />� . . � . . . ' � . , 3PIJJT PLr'1td REQUI^.E.'•�:1TS . . .
<br />.
<br />�. ' •' .; . . • . � Indicate lot s .ze, na:.e of s`reets,
<br />. ; •- - . ' � � 'iadicate locction ar.c wicth of
<br />_ ;'t • _ _ '.•.. . . : . � . ^; : . . a11C� s. 'loczte aro�osed a: d all ' ,
<br />' 1 .�existing 6uildi :gs, shov distances
<br />.. ' • r- �a � ;. .
<br />_ 10 property lines, sho:� disi-ances
<br />' ' ; "4 � . ' . beterecn buildi�gs.
<br />. ., . ' , • ' : , -- ' S.ot size X . .
<br />._- i
<br />. '� . . . . � 7r�t area Sq: Ft.
<br />,! •�• • ' ' � � . . Size of Blag• Sa. FL-. �.
<br />, •,:
<br />- � • Number of Stories ,
<br />.:. �' • • �. IIasenent '
<br />' ` Signed IIy .
<br />i
<br />DO NO°` P::iT?� g_LOhJ T}fI5
<br />: _ DSLC �CCC1VCd 7�.^
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<br />� P13A c:,��;; �;,,-s�= •
<br />�'dllld�lOI1 � � g�� m�.
<br />F�^�it' Fce � �-
<br />Flan Ched; Pcc
<br />� :iutal. Fce nu� �.
<br />�__
<br />. bt.c Tcsucd ^ . . _ 71 � ' '-
<br />�
<br />For •
<br />Owncr Phone --
<br />iJSE
<br />U�e•Zone
<br />F11'C• ZOIIn
<br />Occuoancy Grou� `
<br />TyPc of Construct-ion
<br />Occupir.0 T.oad .
<br />Sprinklern Requl.rad
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