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<br /> � 1QILDING PERMIT APPLICA?,'SON � ����
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<br /> - . . � • . . .' . . . . . . � .����. �' . .., .
<br /> • >pplicant T� Complete Thin :orm �' ,
<br /> . . � • . ' �/of. �j r
<br /> ' , , • !t eoze than one building in to be eontrueted, submit a separate perniit applica-
<br /> ' ., tlOn for each buildinq. ]1 separate permit will he issued ios ear!e huilding.
<br /> , ,, , � �u y(jlii�IF_L�I�f-� ' �/�(�• atiildinq Addrese �7 �(�, (�,/�-/l��
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<br /> . . � 3ddresa ,��2�1I L_/iKc Vrl'[l f�/C . Lot slock ' •
<br /> , . �� C1tr H�JuA r /krt I Phane 7J �F .�>li� sabdivision (Plat) ;
<br /> ' � � �hiteet/Engineer � .
<br /> - �:. c I. •
<br /> _ ','_ , ='1 �h' �, p�+e lletes t Sounds (Unolatted)
<br /> . . .i . . _
<br /> ;, �aatzactor �_/�G� �Uhi H�'iUCJV Sec. 7�rp,�_ Rq� .
<br /> _� .
<br /> -.. _, . i� lEdress �� IU �`fl�{;i�r •� � . ' ' .'
<br /> . t C�tY r\(FI t i i Phone 1F, '�_``��;�, saildinq Use /`(..�1 /�f-��'�T7/�'� ' '•: ;;:�,;
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<br /> : • .�.t# � ttate,License Nmoher � Describg Work to Be Done
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<br /> : • .I �piration Date ' ��{IT"��� ' � t� �-�'S fL�i; � � v �
<br /> ��� � ' . •� ��-C-��-I I/LEA.t F,Yrt -
<br /> � 8�'lC8 PLOT PLAN BEIAW' �
<br /> .' .. �� . • - ' • . ... � .• ,� • � . � � �
<br /> . Qsa of Euildinq �� Il FNI-7/�l
<br /> � i - , • . . � , ,: , _ • QNew � 1lddition t1LR"epaiz/Remo6el
<br /> � . � . ,;' � . . . � • . i. • � .
<br /> . { . ' ' . • • . ' � • '• Valnation of Construction ; � � ' ' �
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<br /> �-� _ �_ ,'. . . . . ' . � � lLOT PLAN REQUIRFI�IENTS -
<br /> -1� ' ' . . " . . . .4 �.
<br /> 1 : ' . � � . . .� . .
<br /> �. � ' ' . " _ . . ' ' ' - ' Indicate lot size, name of streets,
<br /> � ` ' ' � ' '17tdicate location and width of
<br /> ' •'� � ' . '; ' ' - ' j• ' alleys, locate pr000sed and all �
<br /> �' '�� � � - � ' � ' exieting buildings, show distances
<br /> 'tt::,.._ �.
<br /> . . I.'� ' ... .�! : : - •.�h . . tq pzoperty lines, show distances
<br /> : . i , � . ' • between buildings.
<br /> ,. ,, . ' ' �� , ' I.ot size x
<br /> .•i' s , ' � . • Loi area Sq. Ft.
<br /> � r.: � � � � �• '. . Sise of Hldq. Sq. Ft.
<br /> �� � , . ' . '. Itumber of Stori.es
<br /> • �% • � ' • . • Sasement
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<br /> '� ': . _ • Siqned Sy `' J:r�['`+t!. ; ' .�1•� �'��`-�,
<br /> . a . . . . . . . . ( a� � �,,-
<br /> • , • . ' . . . . roz �5/Li� I `lllRt ��/<' �� `( -. /�J�
<br /> • Owner Phone
<br /> , � � � . � � DO NOT it'7ITS BELOI9 THIS LI:IE-FOR CZTY USE Oi7L'! '
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<br /> — •—' Date ��ceived �7 5 Oce Zone
<br /> ' Plan•CSec� :7ur,ber Fire 2one '
<br /> Valnation � `�`�j� �G _ Occunancy Grou�
<br /> PemiE Fee S. e� Type of Construction � .
<br /> � .' ' Plan Check Fee Occupant Load '
<br /> . � Sbta) Tee Due S -� Sprinklcrs Requtred
<br /> ' , Daic Issucd ' (Q�Z1y('� . . ' . .. ' , , . � -
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