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. . . . : - <br /> . I � � S�ILDING PERNIT APPLICATION �/'� � � .•�'j <br /> �- �� � 7lpplicant To Complete This =orm // -�/ <br /> - . � . . c%.�%,'_ <br /> • � if more thin one buildi.nq is to be contructed, submit a separate permit applica- <br /> . . tion for each buildinq. A separatc permit will 6c issued for each buildinq. <br /> . ,' � <br /> " � Ovner -i;,� �, ^ 8uildinq Addtess ; �i; ,' ,v� . <br /> Jddress - - ,�s�� Lot �_ y; ) Block :c���� ' <br /> • City ` '-' % � Phone � " ' ' � Subdivision (Plat) /,� o f' • <br /> ' • lirchitect/Engineer _ � � <br /> '"� City Phone Metes F Sounds (Unplatted) � <br /> - ' 1 . <br /> � Contractor Sec. _ 7t+p. Rge <br /> � - — <br /> ' Address I <br /> - - � <br /> i �ty Phone Building Use _ � ': -�� <br /> ' � . ���� � SWte License tJu�ber Describe Work to !?e Done `�� � <br /> _ ,- , _ _ <br /> , . . ' 'i Ezpiration Dat� ' �„.,,=I.;.�- _ - _ <br /> •� ' - SRETCIS PL�T PLA:4 SELOI•7' ' . <br /> . � . <br /> • • � � � �� .� " _ .— - -�} .. � Ose of Building <br /> • �� � _. ' . .� . � � . .•--. - ,.�. []NeW ❑ Addition ❑ Repair/Remoc�0" <br /> . i <br /> ' ' Valuation of Construction $ ��` <br /> _ . � � <br /> • , � • � � ' PIAT PLAN AEQUIR&�IE:7TS � <br /> -....• ' � � � �i, _ _- ! - <br /> � • Zndicate lot size, nane of streets, <br /> � �� �( . . • - , � ��� . -indicate location and width of <br /> ; . • . ' ` alleys, locate aregosed ar.d all <br /> . ,.'� ' " � � exi�ting buildings, sncs� .3istances <br /> . :. .! . .. , ,� : � . , . to property lines, show distances <br /> � � . � • between buildings. <br /> n <br /> � ' � � Lot size X <br /> ` - � � . Lot area Sq. Ft. <br /> � �� • � Size of Hldg. _ Sa. Ft. <br /> ,� '" � . Numbez of Stcries <br /> � ' , easement <br /> ,-.. ���- . . ��� � -)�� r/ <br /> •� .; � Signed By - r,;�f �. <br /> i <br /> � �- 7 . � � For <br /> � - i" : : 1 t�� �` �� � ` Owner Phone ' <br /> DO 270: S•::2?TL 3=L0�'] iHIS LI:IF.-i0i2 CITY USS Oi1L'L <br /> � � .i <br /> Date Seccived CP/ Uce� Zone . <br /> —T <br /> Plan C:ieck :7u.:ber _ Fire Zone � <br /> �G ' <br /> Valua:ion lD O . Occuoancy Grou� <br /> 6G <br /> Pemit Fee LJ � '' Type of Construction <br /> Plan Check Fee �—� Occupant Load <br /> � ' OG <br /> , ' Total Fee Duc 5• �— Sprinklcrs Required <br /> Date Issued •� 7� / , . • ' . � � ' . <br />