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- , BUILDING PERMIT APPLICATION /��/�%��� <br /> � Applicant To Ccmplete This ^orm <br /> If more than one building is to bc contructed, submit a separate permit applica- <br /> tion far each building. A separate. permit will bc issued for each 5uil�inq. <br /> J( Owner �O wR vc� aa�Y�'h Buildinq Address 2 I I D l"� A v� � 7j <br /> 1lddress �P�� I Ic� '/:, • =% �t i�CU' :%'� •" �'�3Block _ G Pk <br /> City ��� �°v� t� Phone �lL2 -3�6/ Subdivision (Plat) `icL•.-. r : <br /> Arehitect/Engineer Van ;�-en Enc�c' �'� ->� - <- <br /> �;ty F,, ,,.� ty' Phone � � + ' ' "'�-` Metes s Bounds (Unplatted) <br /> Contractor n �!- ' Sec. 1Wp. Rge <br /> Address <br /> Ctty Phone Buildinq Use ' <br /> State License Nunber _ Describe Work to Be Done 1Z �n, ., v � � <br /> Expiration Date " �� � �� '� �"' � ��' "'� ���— <br /> � ' p....�r ' /�_,-:� l'_.:..; <br /> SICETCH PLOT PL11N BELOI� 14.�G . <br /> Ose of Hailding <br /> , ❑New ❑ Addition � Repair/Remodel <br /> , -. <br /> Valuation of Construction $ c�i <br /> � . •� PLOT PLAq REQUIREFSENTS � <br /> • Indicate lot .size, name of streets. <br /> indic:ate location and width of <br /> alleys, locate proposed �nd all <br /> existing buildinqs, show distances <br /> , � to property lines, show distances <br /> � between buildings. <br /> Lot size x <br /> - � Lot area Sq. Ft. I <br /> � � Size oE Bldg. Sq. Ft. � <br /> �� Num6er of Stories _ _ i <br /> � �� ' Easc^cat � <br /> - � i <br /> .�Signed By /�° j <br /> For � <br /> Owner Phone <br /> DO NOT {JRITH 6ELOl� THIS LI:1E-FOR CITY USE O2ILY ; <br /> �_tc ._.---':efl _ U•.e 7.one - — <br /> Plan C::ec;: `tcr`er Fire Zone �� <br /> Valuation Occuoancy Group . <br /> Type of Construction � <br /> Pemit Fee . , <br /> Plan Checl: Fee Occupant,Load f <br /> Total r^ee Dce Sprinklers Required � <br /> Da[e xss��a CITY OF EVERFTT <br /> APPROVED FOR GUILDI��G �':�� � <br /> Date -By----- <br />