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--• „ ' . � � HOILDING PERMIT APPLICATION �� ' '• � <br />j � �1� . <br />. . , Applicant To Complete This :orm � <br />��:�// : �.;i <br />Sf more than one buildinq is to be contructed, submit a se arate ��� <br />•, tion for each buildin3. �1 se arate P Permit applic�jy� <br />�[. P permit will be i�sued for each building. <br />� ; � Oimer i`! ��LLl �lG �� ��-c/ � <br />i r <br />a <br />� <br />. :, " :..I <br />: ,� <br />'I <br />- ri <br />: . �i <br />- .�: <br />..�I <br />� <br />: :1 <br />� <br />''; <br />e <br />Hu ldinq Address / �� � �C -�': <br />Eddress ��„�_ � CC-���- Tqt1_""_`�- Slock f��_ <br />City jLC � Phone Subdivision (Plat) L� '� `�� <br />Erchitect/Engineer ' _ � y � <br />: .. > G/ <br />City Phone M��tes & Bounds (Unplatted) <br />Contractor /k�b ' � � �yvlj,�C'� Sec. �� <br />�'P• Rge <br />Eddress �S /. j' / � ' � � . • : <br />City � Phone� C� ' : � �^ �1 , <br />=�_ ��.� /' /,� Building Use f' ll i ' <br />,, GG NL[ C�vsui',,.�-2- <br />State License Ni:mber � U !' � • '�- ; �' <br />���� �.> cy 7 Describe Work to Be �one /� L�/ ' ���'� <br />Ezpiration Dat� � - � _. ] 5'� � �z }� <br />J. �/— .. <br />� .l� il ^ �Yii ' G ,�/� � '.�i,G /'/ <br />� SKETCH PI.OT PLe1N BELOW' • � �. � _ <br />...- .. y : <br />� <br />Ose of Buildinq <br />. : ❑New ❑ Addition � Repair/Remo:iel <br />. . 4`� <br />� Valuation of Construction $_I,� 90 � �� <br />. � � , PIAT PL71N REQUIRE:�lENTS . <br />, Indicate lot size, name of streets, <br />�indicate location�and wi:th o: <br />. � allcys, locate nr000sed ar.d all - <br />� existing buildings, sho:v distanres <br />.� � � to property lines, sl�ow flzstanc�s <br />" between buildings. <br />• � ' � Lot size y, <br />� <br />I.ot area <br />� ' Size of Bldg �-- Sq. Ft. <br />• ' Number of Stories — Sa. Ft. <br />• Basement '-- <br />�T- <br />Signed By 'e2? 2%�_ <br />For <br />�, Owner Phone <br />DO .JO: Iti:2TT*' H'iL0[�7 THIS LIVE-FOR CITY JSi 027L'L <br />Date Seceived �p� /] �� � �7��e�Zone <br />i <br />Plan Chec:; ;7ur.,ber Fire Zone - <br />Yaluation " /<` � �fJ �'� Occuoancy Grou� <br />Pemit� Fee � / /� . � � . . � <br />Type of Construction <br />Plan Check Fee <br />..� 1bta1 Fee Due � �� ,����-�� <br />Date Issued - •��n �� �/" i 1 � <br />. I <br />Occupant Load <br />Sprinklers Required <br />