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,-,_- � <br /> . <br /> �� - - <br /> , ,. , <br /> - 3UILDINC PER:dIT APFLICATIO:7 ' <br /> ' ��; �loplicant To Ca.^.plete This 'rorm . ' / O' ��/� <br /> 0 <br /> If mo.e than one building is to be constru_ted, eub:nit a separaee pernit .p- 3/�/ � <br /> pli.cation for each building. A seoarate pernit ��ti11 be issued for each build- J7y <br /> iny ^ i . ^ /^ � / �'S 1J� t rY/i d .fll�C <br /> Qaner � I['�ip l- A �' �u �i vn�_ IIuilding .lddress � _ <br /> � ,i '�' Lot7S`�� si�:. 3� s��.�— <br /> ;�r:ress .�/G �'' �c� <br /> City .�c-v��G Phone �/7��' r ! r� iwt, 2Ngy�, S — � <br /> Sub3ivicion (Plat) PL�T �F �'�E�E7�^G �� <br /> �' Architect .SC� '��nUe �- — <br /> City Phone _ l�tetes & IIounds (tinplatted) _ <br /> contractor '�'r-� /�G � ✓c <br /> Address <br /> r <br /> City Pnor.e Building Usc �j /�� .� `" •.� 'y.:�.. . `, . <br /> � SL-ate License Ivumber_ � � ' Describe Worl: to Be Doae _. <br /> /A'�1-•i[ � %� .Oi/ r .l .-Y'��...�. <br /> E>:oiration Date . <br /> . Use of &uildina '7��C.� S , <br /> � '-he�a .. Ad3ition Repai�,e�cdel <br /> • . Valuation of Co�istruct;on Sf� <� ��'� <br /> . . � :LOT PLnN <br /> . . Indicate lot size, r.a^e of streets, <br /> - � � � indicate ?.ocal-ion ��d a:ic:h o� <br /> � . alleys, locate proposed and a11 <br /> � . . . � exist-ing buildings, �how distances <br /> � � � - . to property lines, show distances <br /> � bet�;een buildings. <br /> � • Lot aize x . <br /> • � � Lot• area S.r. ; <br /> � Size of 131dg._ S.F. i <br /> Number of Stories <br /> II�semenL <br /> • Use 'Lone <br /> � '� <br /> _ Signed By�K"�- � L��. ..,. � <br /> For �� <br /> Oroner <br /> DO t:OT WRITE flELOP7 T[iIS LI[4E-FOR CITY DSE 0:7L'i <br /> Date Received ��J' /l' 7�� Fire Zonc — <br /> Plan Check Number � iype of Constructioa , <br /> Valuation /�(9CJ�—� Occupancy Grouy_ <br /> Permit Fee <br /> �Z -�� Occupant Load • <br /> �'-� Sprinklerc Requi:ed <br /> Plan CliecY. Fee ----- <br /> Total 1'ec Duc �Z"� � . - <br /> Pcrnit Numbcr ' • � <br /> Detc Issucd ����- � 5 � ' <br /> APPROv�o FOR Qui�Dir,c rr.r,?.,ir � i <br /> �.,�,• _ <br />