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� <br /> HUZLDI'.7G PERAfIT APPLICATION � � ..: <br /> Applicant To Ccmplete This ^orm � � � , <br /> /�.5� � <br /> If more than one building is to be contructed, submit n separate permit applica- <br /> tion for each building. il separate permit •.�ill be issued for each 5uilQing. � <br /> ' Ownet ��in�c,� ,�� Building nddress � �,Li `�� <br /> Address � � C� 4 d,ot T� (,•,_J Block /d , <br /> City ��,,,; �_ Ph ne 3-> '�'d'QZ Subdivision (Plat) �__�'��Y / �_� <br /> Architect/Lngineer <br /> City Phone t2etes s Bounds (Unplatted) <br /> Contractor Sec. 'iWo. Rge <br /> Address - <br /> City Phone Building Use �-.�.� h Di/E�,� c(��t <br /> � State License ?du;�ber Describe t�ork .o Be Done Q,p wN�7� ��' <br /> r <br /> � /2�r � ' <br /> Expiration Date �-��, ' _ _ <br /> SKETCH PLO'P PLA;I BELOW � <br /> Use of Building �_BJL— //�-`�-� � <br /> � ❑New [�Addition ❑ Repair/Remodel <br /> . Valuation of Construction $ D0 .- f U <br /> � . - PIAT PLAf; REQUIpE:�fE:ITS ; <br /> Indicate lot size, name of streets, <br /> indicate lccation and wzdth of <br /> alleys, locate pr000sed �nd all <br /> existing buildinqs, srto:a distances <br /> ` • � to property lines, show distances <br /> � between buildings. <br /> Lot size x <br /> ' Lot area Sq. Ft. I <br /> , , � Size oY Bldg. _ Sa. Ft. � <br /> - � Number of Stories � <br /> 9ase.^..ent � � <br /> i <br /> -:;Signed 9y �� �� � <br /> ror � <br /> Owncr Phone � <br /> DO NOT {JRITG �ELO19 THIS LI:lE-FOR CITY USE O;7LY <br /> ]:tc .:_ ._. ..'. U_e Zone . <br /> ?!an ....__r. `I�r`cr Fire 2one � <br /> Valuat'r.un _ Occuoancy Group <br /> Pemit Fee __ Type o£ Construction � � <br /> Plan Checl: Fee Occup�nt Load <br /> Total Fec Due Sprinklcr� Required I <br /> Da[c Is�uod � _ <br />