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. ' � . .. '.• , . . DOILDINC PERMIT APPLICl1TION , . . . • .+,'{
<br /> • �pplicant To Complete This :orm . .� .'. :�• � ' i
<br /> . ; . , � . , . � ���.� •
<br /> . . � If �ore than one buildinq is to be contrueted, submit a separate �
<br /> , tioa for each buildinq. A separate Pern�it applica-�L
<br /> A �.� permit will bc issued for each building.
<br /> � ` + /`��S
<br /> . �1 , ' �� �`�L ��`nA.:1n Dnilding Address �� (�
<br /> . � : � y� �" — ^ 1 �-l�ea,,.r� , : ..-
<br /> . � �ddresa _ 1��C��7��� y�r_---L�.1_ —r� r�� .
<br /> � Block �
<br /> . , atY �'� Phone' -�' � g�ivision (Plat) � � �_�� '
<br /> ���'_,
<br /> _ � � 1=shitect/Enqineer �. .
<br /> ' •~'•t�' �}{ �� � p�e Ketes i Bounds (Unplatted) • '
<br /> - . : Oontracto • j�� ) . - .
<br /> ' ;�' �1,1,4ie sec. �. • �� _
<br /> _ , ; . � � .
<br /> : .;• !?• 3ddress � � . �� • , • •
<br /> 5'�;
<br /> / `- .`� —
<br /> • i. «tY d, � �? Phone 1�L 1 �� Building Use . c,:�. '
<br /> •,�;.:: .:.,'�� .�..,..
<br /> '' ',- '.(y� �� State,License N�nnber � ' Describe Work to Be Done ''' �'� `
<br /> , • '.i bcpiration Date • � � ' ��� ,� ;.
<br /> ``1: ."� , . � S1�TCti PLOT PLAN BELOii' •. . _ .
<br /> • � .:� . . . . .:. _ � . . , ' � • • . • � ..
<br /> ... _
<br /> . Q�e of Building �
<br /> '� i . , , � . •�Nev ❑ Addition
<br /> , . .a • . , ' , � . , i Q Repair/Remoc;el
<br /> � � . . - � • • �Valnation of Construction $ I�c,r, ' "
<br /> . r.. .
<br /> � . . . . . � . . . .
<br /> • � .. . ,-• . . '� PLOT PLAN REQUI_RF1�fENTS � .
<br /> � . �
<br /> � • . . . , . . + � . . . ' ,
<br /> _ • •� !. ' , , '. • .� ' • ' ' Iadicate lot size, name of streets, !
<br /> • j ' ' 'indicate location and width of
<br /> _ •; :-` � � . '=�. � . " - :''•;; • alleys, locate pronosed and all �
<br /> i�� ' . ' . - ' �.� � : • ' ti��� •' ' lxisting �uildings, show distances �
<br /> •'n� to propert�f lines, show distznces
<br /> . ' �, ; • ! � , � ' � betxeen buildings. , �
<br /> ' . :'• .',• • . . ' Lot size x � .
<br /> -..i- ' � • � � . . ..
<br /> .' ': Jeot area
<br /> .� ��j f• � � . �.. � ' '• . , . , bize of Bldg. Sq. Ft. .
<br /> � ' • • Bumber of Stories
<br /> ;: .
<br /> i;.. � � . • • ' . Basement
<br /> , .. � . , tA�M
<br /> + • . .• � Siqned By �_
<br /> - 1, � . . : , �
<br /> : . ' . , ' . . For .
<br /> . .. Owner Phone
<br /> • , �� DO NOT F:tITT' HELOM THIS LI:IE-iOR CITY USE ONL'f � � �
<br /> —' —, Date Seceived d" � � � ' D�e Zone .
<br /> ' , Plaa•Chec:; :Iucber � Fire 2one -
<br /> Valnation ��� .�� Occupancy Grou� ' '
<br /> � Petnit' Fee l�, � ' pype of Construction •
<br /> . ' 81an Check Fee Occupant Load • •
<br /> • ., ; Sbtal Fee Due !�- �� -- Sprinklcrs Required '
<br /> Datc issued S � ; •' + . �
<br /> .. . . . . , ,; . , , •
<br /> . . . . ' ,� • . . : . . . . ' . . ..'. • .', . ' .'
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