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. BUILDING P£RMIT APPLiCATION / Q� ,� � � ' <br /> � Applicant To Cempletc This ^orm U � <br /> . ��/3�,� <br /> If more thar one building is to be contructed, submit a separate permit applic <br /> tion for each building. A separate permit •dill be i ;sued `or each 5uilding. � <br /> Owner I_iy�p� ,�. �� )¢fj.SS Building Address ?o�l ICi-c�rr���X' ° <br /> Address 3410 NOSSa.u.._ Lot � - �3 _ 91ock 7�-5 , <br /> City EvPXe�-} Bhone as9-�9�� Subdivision (Plat) � � <br /> Architect/Engi.neer <br /> City Phone _ Metes & Boun3s (Unplatted) <br /> Contractor Sec. 'iDro. Rge <br /> Address � <br /> City Phone Building Use SIY� vni( �'lOYVS— <br /> State License Number Describe Work to 3e Done �r1Su�Ct`�-1 d n ' <br /> , <br /> Expiration Date _ Y2 ��01 CE ,Q�r] S�' ' � Uf <br /> i <br /> SRETCH PLOT PL11l7 BEiO'4 <br /> Use of Building _ <br /> � ❑New ❑ Addition � Repair/Remodel <br /> Valuation of CcnstLuction $ .rjG O <br /> - . � PIAT PI.At7 RLQUIBF"fE:7TS : <br /> , Indicate lot size, name of s:reets, <br /> indicate location and width of <br /> alleys, locate pr�posed and all <br /> existing buildinqs, sno:a distances <br /> . . � to property lines, show distances <br /> � � between 6uildings. <br /> Lot size SS x 8 S <br /> � , Lot area [..�� � ;q. Ft. � <br /> . Size of B1dg. Sq. Ft. � <br /> . ��� Number of Stories ,ct � <br /> � - adSC^C.^.t � <br /> � � � I <br /> Signcd 9y � i n-^ �i�. �lllq � <br /> V <br /> _or ' <br /> Owner Phone .?�9-('��( _ � <br /> UO NOT WZITS ?°LO{9 T4IS LI;7E-.OR CITY USE Q:ILY <br /> ���e . c.�;•;ca � � ��- '� U-e 3one - — <br /> ?1-:n ....eci `:L-`_•�r Fire Zone . <br /> Valuation Occuoancy Group <br /> Pemit Fee Type of Construction � I <br /> . i <br /> Plan Checl: Fee Occapant,Load � <br /> i <br /> Total Fee Due Sprinklnrs Required � <br /> D.7Ge IS=ua:1 � - �. <br />