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' ; � ' DOILDING PEAMIT APPLICATION . /y -2 �. ' ,.j � <br /> - :� • ' . � llpplicant To Complete This :orm /7� .�J � �• �; <br /> i � 6 �y/`��! <br /> , • Z! more than one buildinq is to be contructed, submit a separate permit a plica- <br /> . . tion for each buildin�. (A separate permit will bc issUed for each building. <br /> . " ' Ovner �R.ENE �JEA/sEl1� Buildinq Address �,26�3 �4��5, F✓ere7f':ft.�. <br /> ' , Mdress �(,i'f Cakes, Iq-p7� � Lot /�L Block �p0 �f • <br /> . k�nt�- AS s-7 11 <br /> c�tY _�vere.�fif-' �n� 3f.3 -�iay Subdi4ision (Plat) �/af- of EvPre7t - <br /> ' • I�rchitect/Enqineer � • . <br /> _ _ ':i City � Phone Metes G Bounds (Unplatted) <br /> : C / ��/ .. <br /> :, Contractor n�icV,�in�r7�9'� �.:.X,J�o J Sec. 1++p. Rge � <br /> :' � ': 1lddress �� 1 D �'�G1.CVl._.��; �.( . ' ' <br /> C� �/� c�— <br /> �', City Phone �5,3-�f'Jp (j Huildin Use ' <br /> G�a.-G� s ��.�r e c 1�n 9 •:.=:�': <br /> jj State.License Number .� a 3 -��/s g9�Describe Work to Be Done ` �' '� <br /> . . /� /1 I <br /> � � �I LzPiration nat� J/-� ��/ � � lil.C�v�u � �-(J O 1!�— lC i rGi-,�`�J <br /> :� ' � � � SICETCH PLOT P BELOW' • �� tl'�'� �P�l--✓ � c-?z'L�f"1n.�rf%-7�-7/ <br /> . • , � • , � <br /> : { , Dse of Building <br /> a � � �� � [�New ❑ Addition �Repair/Remo::el <br /> ' � . . . <br /> • - ob .. <br /> � ; : ' � � � Valuation of Construction $ /D o6; <br /> r...� . ' .. . i � . � . . • P7AT PLAN REQUIRE,�IE:7TS . . <br /> � . . .� . � . . � - <br /> . <br /> '. ; • . 2 0 IDdicate lot size, name of streets, <br /> � ' indicate location and width o: <br /> • • � � alleys, locate or000sed a�d all - <br /> �'.1 existing buildiaqs, sho:a distances <br /> . , � '• '! � � to property lines, show distances <br /> , � � � , 6 between bu:ldings. <br /> ' � Lot size �x (� � <br /> , , . <br /> ••• ' , . Lot area Sq. Ft. <br /> ,•„ = Size of Bldg. Sq. Ft. <br /> ' � • Number of Stories <br /> • ' �� i Basement <br /> .•.. . ��,/� �/� <br /> '. '- ~ • Signed By `✓o�<2�TY �i�S.e��'...�+�� <br /> ; (� <br /> ' • — ---- For �� ��� � 1c,s�.�-c--�•✓ <br /> � �Owner one _�t,2—ii b y � <br /> . � <br /> ' DO NOT SiZ?T* 9�LOFl THIS LI:1E-20R CiTY USc 02iL'1 � <br /> Date Seceived c..����'y �� U�e Zon� <br /> �^� <br /> � • <br /> ' Plan C:ieck :Iur..her ' Fire Zonc ' <br /> Valuation �(�(�� • � Occuoancy Group <br /> Pemit Fee � /� • �� Type of Construction <br /> Plan Check Fee Occupant- Load <br /> . 1bta1 Fee Due /�. �� Sprinklers Required <br /> Date Issued �• �J��' �f 7 ) � � . <br /> � • . . / ��/ . . .. ' • <br />