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.� BUILDING PE�dZT APPLICATZON ,�Z � ' <br />Applicant To Complete This ^•orm ���+ <br />If more than one bvilding is to be contructed, submit a se ara� ��/� �'� <br />tion for each buildin �1 se arate P Permit applica- <br />4• p permit will be issued for each building. <br />�er �'���+�A�' y �i/'� Building Address <br />,�G�;�/ l /2a.��t� ,n .� <br />llddress _a� ,� / ��w„� n � � Lot 9-/O -// Block �o/ s <br />City F,/p��P,-.—� phoneaS�Y-ay��/ Subdivision (Plat) �i.�i?P„_� . <br />Architect/Enqineer � , <br />City Phone <br />Contractor A,v��,,,nsn„� /'on��— <br />Address 7�.3/-S�fTr'/J�� i�i <br />CitY _F,�,a,r c•� Phone .j.��- �.�,P? <br />State License Number ��_�_C/ /,j�5'-3 <br />. Expiration Date <br />.' <br />SRETCH PLOT PLAN DELOi4� <br />i9//� y <br />c <br />Metes s Bounds (Unplatted) <br />Sec. T,.p. Rge <br />Suilding Use <br />Describe Work to Be Done <br />Ose of Building <br />❑ New ❑ Addition �y Repair/Remodel <br />Valuation of Construction 5 /ppn,�i <br />FLOT PLAN REQUIREhtENTS <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 buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />Size of Bldg, Sq. Ft. <br />Number of Stories � <br />Basement <br />Signed By <br />For _/-�,�,�r.wi.rn.� v ,A�n f�P'-��/5'�/ <br />Owner Phone <br />DO NOT 14ZI1 : FiELC�'1 :::jS LI:7E-FOR CI'PY USE OtJLY <br />Date Rece:ced / U ����- ) y Ute �one <br />Plan C:�ec:; `;unb�_ <br />Valuaticn <br />Perciit Fee <br />Plan Checl: Fec _ <br />Total Fee Due <br />Datc Issu-d <br />Fire 2one <br />Occuoancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />r <br />9 <br />