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--=-' -- --__ __ _ -�- - - --- . ._ _._ _.... _ .__.._. .--- �- .____. .,� <br />--".'� BUILDING PERMIT APPLICATION I V/ a�� <br />s . 1►pplicant To Complete This .^•orm ��/a��� <br />.f more than one buildinq is to be contructed, submit a separate permit applica- <br />tion for each buildinq. A separate permit will be issued for each building. <br />�er l-(�-��'��-N�� �_ Buildinq Address ;'��{�n% ��2i�f��,,.� <br />xddress �-�(� % � y.-P �t r5th ��� 1 n slock � Sd <br />City �/1 i,' f% Phone „2,� �,�,2 � 2 Subdivision (Plat) _$ �{/,g// cT/¢ /� /S ]" 9dd, <br />Architect/Engineer {� e� �I �� � N.Sn� f 91r, <br />CitY �v>,r;• /,r Phone [/5 3 -1 9it <br />Contractor �t- '�� �_ :__,'� <br />Address /.-�,3 ;�- L( �y�q�qy�,D <br />Citp � Phone <br />State License Number E� � �j-(j /.. [(�QO!/ <br />Expiration Date � f/ � 7� <br />�� <br />� SRETCH PLOT PLAN B�LOW <br />---1-f'4 h1�n e _ <br />,�a <br />! � <br />��'� �\ DO NOT WR <br />Date .^.�ceive3 � <br />Plan Chec% yumber <br />Valuation <br />Pemit £ee <br />Plan Checl: Fee _ <br />Total Fee Due <br />Date issucd <br />THIS L <br />Metes i Hounds (Unplatted) <br />Sec. 1Wp. Rge <br />Building Use S fU�i`�9v S/1 pfi � <br />Describe Work to Be Done ' <br />17c��/r��n/y �a l�p Frr.� rP� <br />Use of Huilding � ��- ��p ' <br />�]New ❑ Addition Q Repair/Remodel <br />Valuation of c'onstruction $ �� <br />PLOT PLAN REQUIREbtENTS . <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate proposed and all <br />existing buildings „show distances <br />to property lines, show distances <br />between buildinqs. <br />Lot size �</� x /� C <br />Lot area `�/pM� Sa. Ft. <br />Size of Bl�g. /'7 ,� p Sq. Ft. <br />Number of Stories �n.�e.. <br />Basement _ <br />Signed By ` <br />For l�-�Q ti C,�v-�� �-c'J <br />- -- --Owner P ne ah � .Y.�a� <br />Ot7LY <br />�- %7 f%ll�� U_ A 7.cne G�Z, �1✓y �e�..,,.'L � LT. /�//��7, <br />7�{��(e�, Fire 2one �?. • <br />Occuoancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />