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� . • ' DUILDING PRRMI'P APPLTCATION • . L�J(_7� <br /> � nPPlicant To Comp]etc This r•or.m • 3��r <br /> If m�re than one bui.?di.ng ir' to be construcl•cd, suUmit a separ.��te //�/�f <br /> apPlicat•.on for each building. A se��arate per.miC wi.11 be i�sucd forre,zch <br /> building. <br /> i OYmer �r�,�,k� ,(����a, �- Building Address , ' <br /> ' /7 �i /7„ �,_., <br /> � <br /> Addr..ss " �-� � ,�,, '1<< Lot <br /> Nloc): <br /> City ��i{�.: � , Phone ,-'., `_ ,��,j' Subdivisi.on (Plat) <br /> Architer.t/Engineer <br /> City _ „ Yhone Metes h I3ounds (Unplatted) <br /> Contractor � Sec. T�,�p, �����_ � <br /> Addrt-ss <br /> City �,u-.,1 � Phone . <br /> .State I,icense Number . <br /> Er.piration Date � . • <br /> � � Building Use • ' <br /> • Describe j�7or): to Be Done u^ '� <br /> CD1��r;^ PLOT PLAt7 ON REti'E?tSE SID:, ��•'C�� �:����.ss�-,=r� - % ,,,� ' , <br /> , G 't'.� <br /> - � Number of Stories <br /> ' ' � � Basement <br /> � � � " Ne�a Addition .Repa9.r./Remodel� <br /> � ' • ' � Valuation of Const�uction $ �t%D, O�� <br /> : ' • ' . ' Signed IIy CC:.iiY-`^ ��� ,,ry <br /> � � . FOr ,/ ' <br /> . .. � _ . Otaner � Phone•�'_�-%/��� <br /> � ', � . . ' � . . ' , J///j� . . <br /> - ' : Do t'ot �•7rite 13c1o�.� This Line -I'or City Use Only ' <br /> . Date Received ' � � � • . ' Use Sone � <br /> IS].an Check Number ' • Tirr. 2one <br /> Valuation ' • Occupancy •Group <br /> Pernit I'ee • 7'ype of Construction • <br /> Plan Check Fee Occupant Load <br /> : Total Fce Due Sprin)clers Rec7uired <br /> Datc Is�ued . <br />