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BUILDING PERI4IT 7+PP7.ICATION <br />Applicant To Compl.etc Thi� 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 bc issued for each build- <br />ing. <br />Owner�i4 hc�� L' � N'�Say IIuilding T+ddress_ <br />Address � 3 6� •>yQ�%� LotL�, IIlk. 7�U Sec. <br />City ��-• ��,� ��_ Phune <br />Architect <br />Ci <br />Phone <br />�p, Rye._ <br />SuUdivision (Plat) <br />bfetes 5 ➢ounds (Unplattcd)_ <br />Contractor�57`i " 'Uut/� �/7l�i����Jy«-�` <br />� <br />Address /3oj /�7/y "��S��L - <br />City,�-=���ryf _ Phone 3S�,i-%Z�� Building Ose <br />State License NumUer'�ZS �-c'/�- ��i�i� Describe S•]orl: to ne �one �1 Y_� �F•�7h'• <br />S +d �� <br />L>:piration Date S- -/` 7 S <br />Use of Buildi <br />'._New _ Addition . Repair/P.enodel <br />Valuation of Construction $�Ocr���� <br />PLOT PL7�] <br />Indicate loL size, name of streets, <br />indicate location and o:idth of <br />alle��s, locate proposed and al]. <br />existin9 buildin9s, show distances <br />to proper.ty lines, show distances <br />beta�een buildings. <br />Lot size x <br />Lot area S.L•'. <br />Size of llldy. S.F. <br />NumUcr of Stories <br />llacement <br />Use Zone <br />Signed IIy� •- :/ � ,��� h. ,'�. <br />Por <br />O�oner <br />DO hOT {4RI1'H $IiIAIJ TIIIS I.Zi7B-POR CITY USf: ONLY <br />Pire Zone <br />Date Reccived <br />Plan Check NumUer � Type oL Construction <br />---- <br />valuation _ Occupancy Group _�-- <br />Yermit 3?ce__ <br />Plan Check Fce <br />Total Fcc lluc_ <br />Pcimit Wumbcr_ <br />Datu Issucd_ <br />Occupanl Load <br />Sprinklcrs Required <br />APPROV[D FOR QUILDING PER�71T <br />n,i„ <br />