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. . DOILDING PTsRlIIT APPLIC7ITION • . S/O� 7(0 '. <br /> S//� <br /> ' 1lpplicnnt To Conpl.etc This Fosw s//f,�c <br /> I! �oze ihan one buildinq in'to be conatructccl, subrft a sep�rnte �erwit <br /> applisation Eor eacb buildinq. A separate per.mil• will be iasuccl for each <br /> bnilding. ' . <br /> prpez fl. ..C'c/�c � 1'r'� ;i '� 8u31ding 1lddress //, /S �ifa�v� � <br /> 1lddress j�;i � � �'sr�,•;. �• • . Lot l Alock <br /> �i� g, �,� ,, ry p}pno fi�bcliyision (Plat) • <br /> llrchitect/Bngincer <br /> City Phonc �_ Met�s 6 IIounc7s �(Unpla�tt.�:d) , <br /> Cont:e�tor FR..� 4••. �/s.,: Sec. 'h•:y,. l:g�:. <br /> )kdd::>s ! / c / I�' =� At� � h< _ <br /> C3ty�� /i[ STc.-�ti: Phone 33Y•749! <br /> .Statt Lices�se Nuwber . <br /> mcpization Date <br /> ' � � Building Use ' . � <br /> � De;cribc �•�ork to De Doue �� ,; �` <br /> 4' ' r. <br /> R �' 1 'y'( ! � A(�'f./+ _ <br /> ��.a.�� �� �� � �.�....�g ^J� • " �' � <br /> .. �,�� � �f�. s. � A�e.�f R�.� <br /> Number oE Stories _ <br /> ' . Sasement _ . <br /> • . - � •' Ne�+ 1►ddition Repai.r/RenodeT <br /> . . . �, Valuation of Conctruction S /O• pO <br /> . . , Siqned Dy �" ` � ,i i/,_.� — — . <br /> : � . . . For <br /> ' Owner • Phone <br /> • � Do I:ot tlrite Below This Linc-For Cit Use Onl � <br /> Date Received '�% ' ' ' ' • � Use Sonc . � <br /> l�lau Check Nusber ""— ' • Firc $one <br /> Valnation � " _ _ ' • Occupancy-Croup <br /> Ye:ait Fee • �� Type of Con�truction ' <br /> Plan Check Fee �' Occupant Load <br /> Zbial Fee Due �� 'r" Sprfnklcrs Required <br /> ' naec Isanea ?�'; ;�•r . <br />