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4 <br /> BUILDING PEF.MIT APPLiCATION ' 2 <br /> � . � � � -� AppBcant To Gomplete Thia Form � � � /� (�✓ <br /> • . _ ' • � L� � <br /> I!more thaa one build�ng ie to 6e eonetrueted, suhmit a separate permit 2� <br /> ' application for each building. A eeparate permit will be ineued for eaeh �!'��/ / <br /> building. �S <br /> Owner�/i��-a /.� : // ��'�-E� Butldiag Address G��7i �-1,P�J . <br /> �� � � �C� l <br /> Addre�■ ``?� /�Z ��/.i y,',cr - Lo �lS Sloe � O 6 �j'O�� l- ' .. . <br /> � ��/ <br /> Citp C� �'l�/��` Phone���- r� ubdivi�ion (Plat) � 1��'�-� <br /> Arehitect/Engiaeer % <br /> � City Phone Metee & Bounds (Unplatted) . � <br /> . � Contractor � See. � Twp. Range <br /> Addres� <br /> , Cily Phone Butiding Uae <br /> 3tate,L3eease Number Deeeribe Work to be Done �-/�`ikr,-/,/ ;;� <br /> FspiraHo¢ Date �� �y � � <br /> �'�Di/1.4>r..%i�, �-Z� 1�-i1L 1� , <br /> SKETCH PLOT PLAN BELOW � � � ' <br /> /c 'V�e of Building <br /> `"_-- \ � � ,�" '4"d� Z j �.4 . IINew QAddition 'IIRepair/Remodel � � <br /> � " ' Valwtioa of Conetruetion S �-{-w <br /> ( 5�1� •✓s•l,k _ 'l� PLOT ?LAN REQUIREMENTS <br /> j�� I <br /> . ' � I i �� Indicate lot nize, name of streeta, <br /> ""'��y ' J �� 1� . . � indicake loeation and width of alleye, <br /> �5� � � . . � lotate proposed and all exiating <br /> , � 1 ,jo � , _ build{ags, ehow diatancea to prop- <br /> � � ' � ertq linee, ahow diatances behveen <br /> . 7-7 � ,S . buildinys. <br /> n . <br /> . I,ot .cze N v ' x <br /> i . <br /> Lo! area Sq. Ft. <br /> Sise of Bldg, . Sq. Fc. <br /> � � � Nnmber of etoriee <br /> . - - -V _1;_ . Buement � <br /> . � <br /> ' Signed.By Date <br /> �` <br /> . ' !'o� <br /> . � �qvne: Phone <br /> DO NOT WRITE BELOW THIS LINE - FOR CITY USE ONLY � <br /> � � <br /> 7�le Reeeived � � U�e Zone _ <br /> . 'Plan Check Number � Fire Zoae _ <br /> Valwtion �i-CJ(� , `� Oeeupancy Group � <br /> Permit Fee � �. �� Type of Conetruction <br /> Plan Check Fee.� ' Oeeupant Load <br /> Total Fee Due �� � Q � Sprinklers Required <br /> Date Ieeued � � � � �^ ' ' <br /> --- - - --- - � � <br />