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; <br />@ <br />. . - --- � .., <br />.� -- . _ ._ __- - - - . _ -�- � --- -- ---.. _ - _ - -._. . <br />�p ; i .; <br />BUILDING PERMIT APPLICATION // <br />Applicant To Complete This ?orm �� � �/� � " � ��// <br />If more than one building is to be contrvcted, submit a separate permit applica- /"77�s <br />Eion for each building. A separate permit will be issued Eor each building. <br />Owner ��it� ��w.Li�;�,p Duilding Address �y',� //F,,.,�%r <br />Address /�f // /%� C,C� s,�� Lot 3 Block �,SJ <br />� 7 j j., �, <br />City �-'fi=f �/ Phone� Subdivision (Plat) � Siy/liw � G <br />]lrchitect/Enqineer _ <br />City Phone <br />Contractor /V!-��/ F3�D �� <��_ n�. <br />Addzess /% y� 9l�' <br />City %-Uj,�s ft Phone �� y-y� y/ <br />State License Number ���-c/ `�'g3�? <br />Expization Date <br />SRETCH PLOT PL}1N BELOW <br />� s <br />Metes s Bounds (Unplatted) <br />Sec._ 7tvp. Rge <br />e <br />Suildinq Use %�L"f,<,✓ <br />Describe Work to Be Done C�r-sf--�-� <br />�CuJ p-;,.�- � Cl,i..� F„n,,1 / :4.�%Y_ <br />Dse of Huilding T� z'a� <br />�New ❑ Addition �Repair/Remodel <br />Valuation of Construction $ �%0� � <br />• PIAT PLAN REQUZREFffiNTS <br />Indicate lot size, name of streets, <br />indicate location and width of <br />� alleys, locate proposed and all <br />existin9 buildings,.show distances <br />to property lines, show distances <br />between buildings. <br />Lot size !1 x /1 ° <br />Lot area ����� Sq. Ft. <br />� Size of Bldg. te Sq. Ft. <br />Number of Stories <br />Basenent ,r/p <br />Signed By ��/1� <br />J� <br />Por SAh� f <br />Owner Phone � s � -�-7� ;, <br />7-�"9-9/ �'/ <br />DO NOT i9RITE BELOIP THIS LINE-FOR CITY USE Of7LY <br />Date 3eceived U_e �one <br />Plan Check 9un�cr <br />Valuation <br />Pemit Fee <br />Plan Checl: Fee <br />Total Fee Due <br />Date Issucd <br />Fire Zone ' <br />Occueancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers F.eauired <br />