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DOILDING PERMIT APPLICATION <br />�pplicant To Complete This Form <br />,.�� <br />..,:Z <br />. , <br />I! nore than one building ie to be contructed, submit a separate permit applica- , <br />tlon for each buildinq. A separate permit will bc issued for each building. <br />Owner /z��F'.�� �=,T% �,�;11 �� .'f : / Huildinq Address � �/?71i/-: <br />T <br />lddress /5/(% �i�i'}9�.it=>� /%t%F= Lot siock <br />City ��/; 4hone 7 �%' $�i� % Subdivision (Plat) <br />lscditect/Enqineer � <br />City Phone Netes z Haunds (Unplatted) <br />Contractor �/11/�,� lii,,� S/-!�� i/7!'//c�j SE :. iwp. Rge ' <br />7lddress ,r�l� %C"X ���j • • <br />City /G;�/�'CtCr''iJ Phone�/�' %�'�� Building Use ��'�>. ::.;.'y� <br />.'�: 1' � • �': <br />State, Lieense Number ��/�/1/ii'S !�7 J�5 Describe Work to Be Done 1' . <br />L=pirztion Date / 7i _ 7i ' ��".i7J/.l _�%�,: �/�G,!% �j%/J:/�'' <br />� SRETCH PLOT PLAN BELOW� • <br />i .. ' <br />I� '_ - - — - .. <br />_�__�=�����r � � = <br />. ;: <br />/^//�'i! �c%/«'E'� . <br />� Dse of Building ��cF:`>"? � <br />� a„��Qew ❑ Acidition ❑ Repair/Remodel <br />v� <br />Valuation of Construction $ �����T � <br />. . YIAT PLAN REQUIRF.h1ENTS , <br />Indicate lot size, name ef streets, <br />indicate location zad width o: <br />alleys, locate nroposed and all <br />esisting buildings, show distances <br />to property lines, show distances <br />betaeen buildings. <br />Lot size x <br />Lot area Sq, FL. <br />Size of Bldg. Sa. Ft. <br />Number of Stories <br />Basement <br />� -' � <br />Signed 9Y `-1L�� "-t- fi%% <br />For '' �;'.. :' �;i � ?f: il'7lr :`/ <br />Owner Phone /' �i� �J-% ; <br />� DO NOT SS:iIT� B5L'J[d TH2� LI:IE-POR CITY USz OiILY <br />Date �eceived Ace Zone <br />Plan Check :7ur..Ser <br />Valuation <br />Pemit Fee <br />Plan Check Fee _ <br />Tatal Fee Due <br />Date Issued <br />Fire Zone <br />Occuoancy Grou� <br />7ype of Construction <br />Occupant Load <br />Sprinklers Require p -�i^,� M'��' I <br />' • ;, • ._. <br />� , � ' :'�R l�% ��a��l <br />. c���x ' oF Ev�r;;_ r'r <br />. L•,:,ir�Ciipn L��t: <br />