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. � � � • � DOILDING PLRltIT 11PPLIGTION .' ,. -'-- . Q.. .—Ir _�'.�� , -�•1 <br /> -� ^' �' � .' , , . � . � �pplicant To Complete This :ot7 • r �� 0 /' •' � . ,� • <br /> . • � i! sore than one buildinq i� to be coattveGed, submit a se aral��/�� � ~ <br /> . . tl.ou for eaen buildin�. .1 se arace P P��it applica- <br /> , p permit will bc issaed Eor eaeh buildinq. <br /> , � ' pMp� MRS. S�n�'OiJ J�tLJfA�.1J Dnildiaq Addzes� � • , ' <br /> ' ' • � saeress l 1 i S� 6 rt A t� p PJ E y,c aioc�c • <br /> � • - . <br /> , dtr 4i1��C12�Tt' thone /dL �—16Z7 �bdi4ision (Plat) : <br /> _ ` �tshiteet/Engineer Q1C1�1►YLV W/�D � . . , . <br /> .'t � . .`� CLtr • Phone Meta i Bonnds (Onplrtted` ' • <br /> ' i ' • ' <br /> � .:�'. CCOtticWr ��L.1LAVO CONST�Cb �V�. �Sec. �1rP'�_ Rq� � • <br /> _ '..'.'_' �Ldress � g o�{ r!�'a � ' . <br /> � • �l Citl r'T.�14124�' PLoae 2� �`�/`� � lnildinq Dse . . •::=•. :t-� - <br /> .. 4 � ftate 7.ieense Nmber l7 1 r 2-4'1!- G • ''�::;.�.. <br /> .. '•i� � pescribe Nork to Be.Done EXTf�Lj� t. <br /> , j�'1 s,�iration nate � 'PjQke wJ0(.L �+9Len[G � Me,tTM � '� . <br /> �i: ' . aaercx rcar rrav BEwx• . _��Co/�rt� U�6 =41No5tArE � <br /> '`'.•� " • , • . • _ • � Ika of Buiididg • . } - <br /> •` i . � • � ... � QHev Q��dditfan �Repair/Reax2el <br /> i •3• . • • •;' ' _ ' � • . �Valaati�f toastrnr.tion S rs � � . <br /> i „��` ••�'. . ' . . �•� :., . ,�. - ! • . _ lLOTPI.IIN �EQOIRE�LN15 . i :�• <br /> � ' •• • •� <br /> � � ' ' ' � ' � ' • ' Ipdicate lot size, naae of strnets, <br /> � : ; , . � . . . •'• ,- _ .iaaicate loea:ica and vidth o: � . <br /> ' - � ' � •' -t'� . • alleys, loeaee ar000sed ar.d all ' <br /> „ i.• . .. . . , <br /> I ;�1 • - � • - =' � existinq bail3iaqs. shov disunees <br /> � -.° l a . �:•"'�� . • , . °+ • . . b0 �ropert! lines. ahw distaaces <br /> I ' i. � �. � betveen buildinqs. . <br /> f .., � „ ' Lot size x <br /> j. : ' .i' � • • .. ' . . � ,' • _ � .7.Ot atea ' ' Sq. Pt, ' . . <br /> • r - . . . . . Siza of H Sq. rt. <br /> 1 � '� - ' ' ltumber oE Stories--� <br /> � .�;. ' �: .i - � . . . Dasemen <br /> � '�-�:� � • � . . , . ilqded B'y �� ' . <br /> . ;- • . ' • : ' �• Yo= Mes siMON �1EsNun*�D' -_. <br /> •� ' . ' Ovner P ne <br /> • ' . . , �DO :iOT A�tITE B°:.fIFJ TF!IS LS:iF, 'OR CITY OS� O:IL'!� <br /> . Date ��eeiocd �O 7 � Wx� Sone • ' <br /> ' ?lia CAce.,:7�Sez � ' ' lirc Zonc ' ' <br /> Yalaation �z '-(O (� f`—' � ' . <br /> • . • Oeeuoaacy Gro�Q <br /> ttmit £ee �{-C�. `�U ' . lype ef Constiuetioa . <br /> ' ?lae CAcek Fee Occupant Load • <br /> . lbial Fee Due �-C� «' i�rinklers Reqaired ' • <br /> � �� � aae� is:��a J c��f'�h s� ' • . • ' �. . . <br /> ti � . . - . <br /> . . - , . ' . ' . •' • , . <br />