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RUILDIt7G PERMIT APPLICATION � /� � T� <br /> Applica�tt To Comp!ete Thia Form <br /> ��,����r <br /> � If more lhan one building is to be conetructed, submit a separate permit <br /> • application for each building. A separate permit will be issued for each , <br /> building. <br /> � - ��� 1 Building Address ��� ���-�� �� , <br /> Owne � -- VJ �/� f��C. SC> l�l3'. /�7S-., <br /> pddreas 1 ? _ Lot � Block <br /> h �(� (� QC `.�lQI;�J ' <br /> Cit �. PhonN�l�-� ,�1�1 Subdivieion (Plat) �cC�C- � i �_ ,f �� ) <br /> Architect/Engineer . <br /> City � Phone—�. Metes & Bounds (Unplatted)�_. <br /> Contracto��Vy�^ � ���eC' T���'—Range�— <br /> Addrees��,i .�)�t,a'C�� .l <br /> City,,�,� � k�l _Pho� �Building Use <br /> State License Number,-�7�0(J-r��-��`1"�O"escribe Work to 6e Done���_ <br /> n (� <br /> ' � 5 :�-�r�\ 1 � 1l fYY�l Q t i 1 J\ <br /> . ExpirationDate �i �,-C�� � <br /> SKETCH PLOT PLAN B�LON <br /> Use of Building <br /> .L7 New L7 Addi[ion�Repair/Remodel <br /> �� CO <br /> � Valuation of Construction 5 �f �. <br /> PLUT PLAN RLQUIREMENTS <br /> Indicate lot size, name of stree[s, <br /> indicate location and wid[h of alleys, <br /> . locate proposed snd all e�isting <br /> buildings, show disWnces lo prop- <br /> � � erty lines, show distances between <br /> buildings. <br /> Lot eize X�—� <br /> • • Lot area Sq. Ft. <br /> Sq. Ft. <br /> ._ Size of Dldg.�_ <br /> Number of stories <br /> Basement <br /> Sig❑ d By Date <br /> i \ <br /> ,.For �, \� �� �v�� . I <br /> � Owncr Phonc . . �- <br /> DO NOT NRITE AELO�V THIS LINE - FOR CITY USE ONLY <br /> Date Received Use Zone . <br /> Plan Check Number�� Fire Zonc <br /> \�'{C.�,I,�. GC Occupancy Group <br /> Valuation_� � <br /> Permit Fee � Type o[ Construc[ion <br /> Plan Check ree Occupant Load <br /> Total Fee Due___ _ Sprinklers Required <br /> Date Issucd � <br />