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� • BUILDING PEAMIT APPLICATION / (�, ��'i <br /> • • • Applicant To Complete This ^crm / 3�/�� <br /> ' If more than one building is to be contructed, submit a separate permit app ica- <br /> ' tion for each building. A separate permit will be issued `_or each buil3ing. , <br /> Owner '>a y ,�i F �F Buildinq Address .� . . % � r �� `-�-' <br /> ��-l-'-_-`^�� <br /> f�'�� i-- i� Slock `1� � y' <br /> Address �/'7 �� !-G � .l r ' �:J � .�'' Lot ._ , - <br /> �4 <br /> City ; f/f` P 7 i� phone `-' Subdivision (Plat) � �' <br /> Architect/Engineer <br /> City ��_Phone Metes � Bounds (Unplatted) <br /> Sec. 'iWp- Rge <br /> Contractor � , <br /> �,,�; � Address . _ <br /> ��- '� Building Use � �- �� • <br /> . '' . City Phone . <br /> `'� ;�� - Describe Work to Be Done ��� �+J_ <br /> 'f�?�: State License Number <br /> w;'. <br /> • Expiration Date � <br /> � ':, i SRETCH PLOT PLl1N BELOS4 �, , . <br /> , �T Use of Building ' � �'" � <br /> � 1 , , <br /> � ❑New ❑ Addition [�Repair/Remodel <br /> � '� ' J� Valuation of Construction d V � <br /> 16-- � <br /> '�' I - '- — - PIAT PLAN REQUIREAIECITS • <br /> �:��;;: � rc `i F =� ' � <br /> ;`�,= �,: � <br /> ¢ - �: I Indicate lot size, name of streets, <br /> ,��j, -, ,' indicate location and width of <br /> � alleys, locate pzoposed and �11 <br /> �� �'�`�;;; p � � existing baildinqs, show distances <br /> X)� to property lines, show distances <br /> � ° � j . between buildings. <br /> � -._. <br /> I � " ` ' . Lot si2e X <br /> • Sq. Ft. <br /> � -- , ,`. Lot area g4. Ft. � <br /> Size o: Bldg. — i ' <br /> ,.. • j� Number of Stories � <br /> • ' x i Haser..cr.t � <br /> { _ _ -� - °-�-3�� ,.,, ; <br /> � si nca E � <br /> a Y <br /> , -:t�,+ g , <br /> � :� .,.1�c.��� ��i � ;.r�r . . . - '. <br /> / ;�! � <br /> " � kor ' ,t.-1„__i. . .. . . <br /> Owncr �Phone �__ <br /> � � <br /> ' � DO NOT WRITG �3�LOW TNIS LI:1E-FOR CITY USE O:ILY � <br /> �.`c "..:c�:•:r:., �/_ `���- 7=" _ U:e 7.one - — <br /> =1an C::ec:% `7cr_-- -- <br /> Fire Zonc <br /> Valuation U�n P' Occuoancy Gro p i <br /> Q� Type of Construction ; <br /> Pemit Fee �2 • . <br /> Occup�nt Load � <br /> Plan Checl: Fee � I <br /> Tota1 r^cc �ue , Sprinklers Required �-- <br /> � /. Datc Is�ucd J-�t ��(�'�� � ' <br /> ILl <br /> � /0: 30- !/:oa � <br />