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HUILDING PERMIT APPLICATION j p� � �'���� <br /> Applicant To Complete This 9orm � <br /> If more than one building is to be contructed, submit a separate permit applica- �J///�/j <br /> tion for each building. A separate permit will be issued for each buildina. <br /> Owner �4 Y��'°�� �� h� t t��l Y� Building Address ,;3� �C� ��.C�LC�:� � <br /> �ddress ��;�� �/�l �� CZj p � � Block �' <br /> �', - Lot�__ _ ��n,_ )�� , <br /> City ( ( y.ji�ti�_ phone,- � ' <br /> _i:l� 1��{ Subdivision (Plat) �i �p1C$fl n --,� (�� <br /> Architect En ineer ' ' —`� -�'' <br /> / s' _ � S�ctrQ {� <br /> City _ Phone Metes 6 Hounds (Unplatted) <br /> 0 <br /> Contractor ` �Il�'��C lC' ,��i����eQ, <br /> (� l - �'P• Rge <br /> Address ��,1'� C �u.')Pl'1S'CM �.l.�U� <br /> City -� Phon�le � --�� Building Use ` . <br /> Q�Oiti ' � <br /> State License Number �`j�,�_C���_� �,,��S, �escribe Work to Be Done � <br /> E�cpiration Date (� - �L, -��5 , � <br /> . . — __ � � �. ., �-� . <br /> . . � � <br /> SKETCH PLOT PI.AN BELOW C\Z�����„ _ <br /> Ose of Building ��G� � • <br /> C1New ❑ Additi.on `{�'�pair/Remodel <br /> � Valuation of Construction $ �n�;n oc ' <br /> ' PLOT PLAN REQUIRGffiNTS <br /> Indicate lot size, name of streets, � <br /> - indicate location and width of <br /> alleys, locate proposed and all <br /> � .� existing buildings, .show distances <br /> � � to property lines, show distances <br /> . ' between buildings. <br /> . ' Lot size x <br /> , Lot area Sq. Ft. <br /> Size of Bldg. Sq. Ft. <br /> ". � Number of Sto�ies <br /> ' Basement <br /> � � . <br /> Signed Dy � <br /> L•br I <br /> Owner Phone <br /> DO NOT WRITti DELOW THIS I.ZNE-FOR CITY USE Ot7LY !f <br /> Date ^�ce:ced /�--/�.� 7� �,�i , � <br /> U�e Zorte <br /> Plan Chec�: 9u�ber Fire 2one � � <br /> Valuation Occuoancy Group � <br /> Pemit Fee �Q � � <br /> Type of Construction ' <br /> PLan Check Fee Occupant Load <br /> Total Fee Due Sprinklers Required <br /> Date Is�ucd {_.. ., .. . .. i. ! <br /> I <br /> n�t-„����,���_� � ���' , _..._. � .� � �:ir <br /> _ _ _ -- �_ : . . � _ � <br /> �_�:. ��� . <br />