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_ <br />- - . -- - <br />-- - -_ _ . _ _-- - -._ ...� <br />, ' BUZLDING PERf4IT APPLICATION /X��� ���? <br />1lpplicant To Comp.ete This ?orm � ✓p� �� <br />Zf more than one building is to be contructed, submit a se arate //�v /�. <br />tion for eac :i13in . el se arate '� Permit aoplica- <br />/'�� permit will bc issued for e.ich building. <br />owner /� i1//i/�fG/Zt / <br />BuildinR Address `�Ol �r/j 1/�� <br />Addiess �/ ��(%, Lot �" c7� e� Hlock / f? �j <br />City ��'� G�p P�� phoneY � r Subdivision (Plat) `— <br />u���1�, _i�oh ��/i PF/ <br />Architect/Engineer � <br />City Phone t2etes 6 Bounds (Unplatted) <br />Contractor f_��� ' - <br />—��� Sec. _ �itap, Rqe <br />AddrEss <br />City <br />State License ;Iumher <br />Expiration ❑ate <br />Phone <br />SKETCH PLOT PI.�1N AELOI�i <br />nn <br />DatC .._ce:7Cd <br />Plan Ch^cF: ^Icmbcr " <br />Valuztion �-�j� <br />Pemit Fee ���� <br />Plan Checi; Fee <br />Tota1 Fee Due <br />Datc Is>ur3 <br />3 :�0[! <br />Building Use ��PS � �!� h Lti � <br />Describe Work to Be Done <br />%/.i n � �� /'P< �n �� !�i .r <br />Ose of Building � <br />❑ New 0 Addition ❑ Repair/Remodel <br />Valuation of Construction $� 6 Q - <br />PLOT PLAN REQUZ4E61H,]TS <br />Indicate lot size, name of streets, � <br />indicate 'ocation and width cf <br />alleys, locate nroposed and all <br />e;cisting buildinas„sho;✓ distances <br />to property lines, show distances <br />between buildings. <br />Lot size X <br />Lot area Sq. Ft. <br />Size of Bldg. Sq. Fc. <br />Number of Stories <br />Basement <br />Signed By <br />For � <br />Owner Phone �,,--�7-'Q <br />,�_:cLp � <br />USE 0:7LY <br />U:.e Zene <br />Fire Zonc <br />Occuoancy Groua <br />Type of Construction <br />Occupant Load . <br />Sprinklers Required <br />��� �� �1��/��- <br />8 <br />; <br />