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. . , . <br /> • IIUILDING PTiR1:IT APPLICATION • ' �' J � 9C <br /> •� ApplicanL To CoinpJ.etc Thi.s Por.m � S�C . <br /> If moze than one bui2ding i,� to be consiructed, suUmit a separ.ate per.mi.t <br /> applicaLion for each building. A separate pe�'miL will Ue is�ucd for. cach <br /> Uui'_dir,g. <br /> .l ,/ <br /> Owner � C�� _ �i✓•r/C-i� Buildin�J Address ��- (�Zl�'r�� : cf. <br /> nddress yG ' � • . . Loi: 131oc1: <br /> City 4 i�c�� _ Phone��— �32 f Subdivision (Plat) � <br /> Archi�ec{:/�ngincer <br /> Citv Phone MeLes & IIounds (UnplatLecl) <br /> ntrzctor �.,,,� s . "« - c �. Sec. T�.�p- Rge• __ <br /> iAaar.�s l��� -� �� ���. <br /> City L)' �C/,> >,..r � Phone � 'Ll�`f , <br /> State Licease Number � z3 f� Y 3���' • <br /> yr.piraticn Date <br /> ' . Building Use ' �. <br /> • Describe Z�:or}: to �e Done <br /> • �2, " y'�'/2_ ol i p__ � e <br /> C01-PT�:_� PlOT PLA2d OV REVEISE SID� ---7` <br /> Number oi- Si:ories , <br /> � . ' Basement <br /> ' • � . . .. � lsew Addition Repai_r./R�model' <br /> �� <br /> : ValuaYion of COn�L-ruction :r �S -' <br /> . (o �� �i,.�..� <br /> . _ � Signed IIy � " , <br /> . . • . For �' �''.� .' <br /> ' Owner • Phone G L�F <br /> � • Do t�ot idrite Belo�a This Line -P'or City Ose Only <br /> Date Feceived " " � � • � Use Sone ' <br /> Islan C�ecl: Number ' • Firc: 2one <br /> Valuation ' •_ Occupancy -Group . <br /> Pernit Fee • . Type of Construci:ion �_ <br /> Plan Cl�eck Fee ' Occupant Load <br /> Total I'ee Duc Sprinlcicrs Required i_ <br /> Datc Issucd • <br />