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HVILDI�G PERMIT APPLICATION /9�� � <br /> � Applicant To Complete This ^•orm � _ / <br /> If more than one building is to be contructed, submit a separate permit appl ca�� <br /> tion for each building. �1 separate permit will be issued `or each building. t <br /> rj <br /> Wner � . 1)n • ' - - Buildinq Address % ;' `/ �7' <br /> // ! /, ..._ % Lot / � Block /rr7_; - D ;-�•' <br /> Address ,�� y !�-c ,;> : • <br /> City r /, Phone�S'.�-SkG7 Subdivision (Plat) <br /> � /J <br /> Azchitect/Engineer ��i�� /j-�" � � r '(U-�" <br /> City Phone Metec s Bounds (Unplatted) <br /> Contractor /y�--� � �n ;- :'•_= `�_ Sec. 7wp. Rge <br /> 7 S3 �- � ' . <br /> Address nc,�-c F /5, ;io-.� '• � <br /> City !_ ��. Phone 353- �/G�7 Buildinq Use /1��� � �•= •- <br /> State License Number .�.- �5 � �'/- C l : �- Describe.Work to Be Done �i��:•-��-i�� � ' <br /> ' � � �� <br /> Expiration Date /_/�/7� / � � ' �� �''� t} `+� � �� c " �� <br /> SRETCH PLOT PIJ1N BELOW �� �: , '>" �'� r�^�.��. <br /> ' tlse of Building <br /> , �Iiew ❑ Addition 6�Repair/Remodel <br /> Valuation of Construction 5 G G d � <br /> � <br /> � . , .. PIAT PLAN REQUIREDIENTS '. <br /> . indicate lot ,size, name of streets, <br /> � indicate location and width of <br /> � � alleys, locate proposed and all <br /> existing buildinqs, show distances <br /> � . to property lines, show distances <br /> ' • between buildings. <br /> Lot size X <br /> - � Lot area Sq. Ft. <br /> � � � Size of Bldg. _ Sq. Ft. <br /> • • Number of Stories i <br /> ' " ?dSC.T.C.^.t I <br /> I � Signed By i �'r 'i,-'1.l t- � <br /> I <br /> � For <br /> Owner Phone � <br /> i <br /> DO NOT WZITB ➢�LO[9 THIS LI.IE-FOR CITY USE O;ILY j <br /> �stc ..r.c�:•:ed U�_e 2one - — <br /> I PLan C::ec� )lur.:er Fire Zone � <br /> i <br /> � Valuation Occuoancy Group <br /> � <br /> eerciit Fee Type of Construction � <br /> I <br /> Plan Checl: Fee Occupant Load � <br /> Total Fee Due Sprinklers Required � <br /> Datc Issucd � � <br />