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• DUILDING PTsRMIT APPLICATION • -� � '��• J �' <br />. , . , �� �c� <br />. Applicant To Comp].etc 'J".ii.s 1 orm <br />If more than o»e buil.ding i�' L•o Ue consi:ructed, submii: a separ.nL•e per.mi.L- <br />applicaL•ion for each Uuilding. A �eparate ��enuiL• w5.11 Ue is:i�ecl for. each <br />building. * /� ' • <br />O4mer IIUS.��ZS�� !'��LCJJ gy'll �/I�/� <br />Address ,� �%.7�% Lot /b — l � 131oc1: �iys— <br />City� Phone Q,C — / %6 � SuUdiyisiat (Plat) ���t t � "r <br />Archi:ect/•nqineer <br />City Phone Metes & IIomids (Unplatted) <br />ContracL•or � Sec. T���p. _ Rge. <br />Addr`_ss <br />City Phone ' <br />State License humher <br />Er.piration Date � <br />COh1�T.,' `' PLOT PLAtd OV REV�I+SE SID� <br />Building Use �d��+.�}- <br />Describe �•Iorl: to IIe llone <br />��� / ,.%� <br />Nutnber oi Stories <br />Basemeni: <br />t�er� Addition Repai,r./ltemodel� <br />Valuation of Construction $ <br />. . � Signed IIy �_ <br />. • For <br />� Owner Phone,'(� 7� s9� <br />Do t�ot P�ri{:e lle].ow This Li.nc -P'or City Use Only <br />.. . .. " Use Sone : . <br />Date Received ' <br />IS].an C�ecl: NumUer ' • I'ir�� 2one <br />Valuation ' • Occupancy•GLoup . <br />Pernit Fee • . Typc of Consi:r.ucL•ion �_ <br />Plan Check I'ee ' Occupant Load <br />Total Fec lluc Sprinlcicrs Required .�_ <br />Date Issuecl • <br />