|
� IIQILDIIVG PERMIT APPLICATICN f �.� •
<br />_. .� , .. . .... . ���.�
<br />, � lpplicanr To Complete This :orm / � ,
<br />. , � , 5j�.,Z�l
<br />', ' Zf more than one building is to be contructed, submit a separate permit appl3ca
<br />- ..; tiop for each buildin-/g. .1 separat.e permit will be issued for each bua.ldinq.
<br />� � Ormer 1•��, �T . /��-�G`/t'y /�'1�'� � Gh )��. Huilding Address ��� (� � ��"j�� .
<br />�
<br />�
<br />. � � � -7 -,
<br />y 3ddress �� �' � f,IC'L �'1 7 c�� Lot / 7 � 7�' Block l� '" ,� •
<br />l, �-`-
<br />' , City -�!��11 1 �l- Phone �,:Jr- �j �t:�� Subdivision (Plat) �-ii%`T�l�/ i i- •
<br />. � . � /-
<br />, . . architect•/Engineer ��` � � �G�"��1_ �G/.�G �CL- 1 � � � 3 ,^� � � ,
<br />, • '_�� . `c'i City�27� j'�L.� Phone -��,� —<��%?c: Ketes L Hounds (vnplattea)
<br />_ � . ;,� Cantractor ��v��.7�� �����N��tl�� �G Sec. 14ap. � Rge ' - .
<br />., . 7�, �p r
<br />-.. _, .• i• Eddress� e'� c1 JC�K YCI�U . .
<br />- ' (+ � � �
<br />. !: City ��-� �� r _ Phonr �J-'l %�'�-C� Building Use ( c:�}f- C ��� ��' . , _•; _,�'!.
<br />...:�7 . .�::.:� � � _ . -� -
<br />b} State.Licei�se Ni..-�abes 223-0/-' Z��i1 Describe Woxk to Be Done ��` �
<br />�..• •'.1 Lzpiration Dat� d/ � ��1C{ Y`�Iv�'�c'-i��iNC%r��}tf C L 1'��
<br />��' "~ % S.'.ETCFi PLOT PI.AN BELOT+7� • C��I.C(` (< ��"�� (,�C�� C �P_ . - ..
<br />- • - � . ' ' . . . .
<br />,' i� . . - . . . . � IIse of Building
<br />i
<br />a � '. ' • � � , : , , . • �New �] Addition Q Repair/Remofiel
<br />� • � . .i - . . . � ' . : ,� i ' .
<br />. � { _ ' • - , ` r . '. 'paluation of Construction $ .� h G C.+Z,' " �
<br />�• . . , ����'a�-.
<br />+- � . . � ' ^ . - PIAT ?LADI REQUI_^tir..�LNTS �t.�cE.
<br />.�, . . , � . . . � .
<br />. . . . .a . . � .
<br />,.3 - ' ' "' - ' In3icate lot size, name of strects,
<br />� � '' ' � � .' � � ' ' ` •i:.dicate locaiion and width of
<br />• � ��� ' . � •� ' = . , • alleys, locate provosed and all � �
<br />� . '� �::i . . _ - '_ ' � ' : . -_ _ � existing buildi.-.;�, sho:o distances
<br />. . :'� ••- �� "�'! . • � �~'s � - . to property lines, show distznces
<br />� ; f ' � . ' - : between buildings.
<br />. . � . • . -• . . .
<br />� . ' I.ot size x
<br />• , ' Lot area Sq. Ft..
<br />�•. Size of Bldg. Sa. Ft.
<br />. ' Etamber of Stories
<br />� . � � Baser�ent ,� �
<br />i �� �
<br />' _ . � Signed By �l � '• � � ���r Ql� � � . "
<br />� � � � . . : � For C`L%/�- ���i� ��`�e�•�:c� r�?�ti t:«��C�'��
<br />� � - ner Phone
<br />��. � � � DO t70': S�':iITE B�LOti THZS LINE-FOR CITY USE 0:7L'i
<br />- •-. Date `:eceived 'S /`�/� J IIce Zone
<br />, �'-7
<br />' Plan. Cyec� :lur.ber 7S -Z3 � Fire 2one '
<br />Valnation �
<br />SS �iLi� �- Occunancy Group
<br />• � C}�, OC
<br />FemiE Fce � ��% Type of Construction
<br />� . .' ' Plan Check Fee _(ZL�. `��_ Occupant Load •
<br />. � Sbtal Fee Due .32 ��- Sprinklcrs Required
<br />, Datc Issue3 '
<br />-- . . "71.��2�+r�fi•�� �-- . .
<br />��• ,����� �v. �. ;' .
<br />•� .
<br />
|