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BUILDING PERMIT APPLICATION <br />Applicant To Complete This Form <br />If more than one building is to be constructed, submit a separate permit ap- <br />plication for each building. A separate permit will be issued for each build- <br />ing. <br />Owner <' Ilk, Sn/' ' /-� � �C v t._ � ! � Building Address //c Y7- <br />Address�f S c' '7.f' f > /'i s L Lot t ; 3 Blk. .7.:: Sec. — <br />City l.r s r> 7 <br />Phone Z C -> Twp• — Rge. — <br />Architect _ <br />_ <br />subdivision (Plat) <br />City <br />Phone Metes 6 Bounds (Unplatted) <br />Contractor C'i X SC-& -Y i-Cc c-- < Z- S <br />Address r.SC' <br />='�.G of �'/-t G e <br />City Lr.P A'—, T- <br />phone -2 C-%C'"L Building Use .F'f ` rdli -rflC <br />State License Number" Describe Work to Be Done Prrur'ct7F <br />Expiration Dat <br />1c('z-7slTfe/1 "- i"f c.c k er/p, Ex rSTrr•.,C— <br />sxy STUDSO. ` - 'c ��� c' 7c arc P /Sl/L6 <br />-SUB FtocC <br />SOLE Port 4tjjb3bvrUse of Building <br />AfewA.4- D it <br />TVK;b,dj <br />RIM 10'sT Now Addition X Repair/Remodel <br />FL00R SO�SSS <br />I ajrrd=poi2.. <br />A.BaLT Valuation of Construction $ <br />- <br />FOTM GRA06 CEDAR, . <br />rwm "W A.6, PLOT PLAN <br />F" 04Cc43 Indicate lot size, name of streets, <br />indicate location and width of <br />FG,�A <br />alleys, locate proposed and all <br />— existing buildings, show distances <br />_ <br />to property lines, show distances <br />between buildings. <br />Wyeg y 32110,c" Lot size '2 S x i 2L <br />i►56sfey s5'o.c. Loot area Go -, S.F. <br />S.F. <br />Size of Bldg. <br />4U25avT7umber of store <br />_ Gc/15 covP+llJ1tr Zone, <br />P.B-57BSC signed By V ' ka\'j rtj <br />I- i5 <br />For (s!/SC✓L fT '�/Cc LVS <br />}� <br />Owner <br />Date Received .23 q 7 3 <br />Plan Check Numb 7S <br />Valuation l� <br />Permit Fee lZ) <br />Plan Check Fee <br />Total Fee Due /io <br />Permit Number <br />Date Is <br />S LINE -FOR CITY USE ONLY <br />Fire Zone <br />Type of Construction <br />Occupancy Group <br />occupant Load <br />Sprinklers Requi <br />4,0et-Voecd• �Z'//4 77 <br />SU'3Sc'GT to GcdNG -M�`G <br />P.(JClGN � 1Z8�`�'19.Ne�LQ <br />APPROVED fOR BUILDING PERMIT <br />n,v,. <br />