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� HUSLDING PERMIT APPLICATION / �/�� <br /> j Appli�ant To Complete This Form ,��1�� <br /> If more than one building is to be constructed, submit a separate permit ap- <br /> ingcation fo��uilding. A separate permit will be issued for each buzld- <br /> .' ,{ �J i <br /> Owner, I, !�. ��,�i •% J.��`-�;� :�.>.- =�. � Building Tddress �i � `: - . ,t-.%� <br /> . � <br /> Address Lot Blk. Sec. <br /> City r/�� - ' Phone Ztup. Rge. � <br /> Architect ' Subdivision (Plat) <br /> City Phone Metes & Sounds (Unplatted) <br /> Contractor S' � :./- ���. <br /> Address ,L �,:j6 �RpN!�� <br /> City �✓�"/'F_ ) T Phene,°S'J +`,?�'f' Building Use <br /> State License Number' 1��� T/='S'ayo Describe Work to Be Done ]��r/�fCE 6LASS <br /> Expiration Date�/2-/�9- 7,�" l3RD�E/� ld� T# /;uF'�> � coNs. <br /> _ � .' - ti'fl,rKt S' �.i r.'l n E �� x t'l-,t s7c�.',�'.Y'_'�/,;�J'r�r-'. <br /> Use of Building T„!/�,�N <br /> � . <br /> � C J. '�New _. Addition ., Repair/Fenodel � <br /> ��� - � � Valuation of Construct�on $���� <br /> _ -- - Exisr�v�, ;-.-�z.,-u <br /> . .�-'' . � - . PLOT PLAN � <br /> ' _ ...._ .:.,;. . . _, , --�- --- <br /> ' Indicate lot size, name of streets, j <br /> - i indicat-e location and width of � <br /> • alleys, locate proposed and all � <br /> � � � ,� . existing buildings, show distances : <br /> ��� � to property lines, show ilistances <br /> , i between buildings. I <br /> " `7 �/ 1 J%� � LoL size ' x <br /> � `�`;�. � �, � - Lot area S.F. <br /> ��I� � � '�ti f� f , � Size of llldg. S.F. i <br /> J,x�(57Vd� , �pl Basementf Stories � <br /> � � � Use Zone - <br /> _ �,; ,{�� ,6igned f �� I <br /> � � sinr �,.N�.� . ✓ Foz � <br /> Owner <br /> DO OT WRZTE IIELO�V TIIIS LINE-FOR CITY USE ONLY <br /> Date Received Z S � Fire Zone <br /> Flan Check Number � Type of Construction � <br /> Valuation �C� �— Occupancy Group _ <br /> Permit Fee S. Occupant Load � <br /> Flan Check Fee Sprinklers Required <br /> � Total Fee Due S�� ,� � � � - <br /> � Permit Number � . � <br /> � Datc Issued �/Z�7� . . <br /> —T <br /> APPROVED FOR pUILDING PCRMIT ' <br /> n.�., <br />