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: <br />: • DUTLDIPIG Pf.!tMTi' APPLICA'PION . . / % � � 1 _ �� <br />• Ap�licanL• To Compl.eL•c '�his. lorm � �c��C� <br />Yf noze tlian onc building i,�to Ue constructcd, subt,iit a sep�ir.nL•e rer.mi.L <br />apPlicat.ion for each building. A �eparaCe pea-�uit �•ii.l.l be is_ued for. rzch ' <br />b��ia�r�3. I /� J/��c�/7& <br />O�mcr ,�p ti�Ya cw5 �O w� /Cuti.,,S Building Addri:ss `p z.'� Uq K�.S �iu.� <br />naaress 5�3.3� ��,�Y y v�x—�� Lot ,3_,,/ 9a� Z c:� _�io�r #/ <br />City ����,� Phone Z,jy /�ult . Subdiyision (1'lat) • <br />Archi.ect/Engineer 1�„d„T,e3�___ ra;,, ��yu. i. K► *'��S �vs d'- �,b p. <br />City v�v�� Phone S-JZuo Metes & IIounc's (UnplaLt•ecl) <br />Contr�ctor �,tj�iaru� G�...� o�'o�i.,,:._( Sec. T���p. _ Rge. <br />Addre_s y332 / �,t,-4r� \ <br />CitY �,tv�c.# Phone �.JS /o� I ' <br />State License t.umber 2230/-/8'�2G <br />Er.pir>_tion Date z� 7 7 <br />C01^PT�_"_= PLOT PL<<N 02� �V�I'iSE SIDE <br />iT <br />Date Reccived _ <br />Islan C:�ec): NumUer <br />Valuation � <br />Perr�it Fee <br />Plan Cl�eck I'ee <br />Total 1'ec lluc <br />Datc I�sued <br />Building Usc 'SiNf�w���k� � <br />Describe �•:or}; to Be Done <br />Nir✓ Cu►.. S C'rY�w�i c-r--- <br />Number of Stories UN�. _ <br />Bus -nent �v <br />' Neta Addition .Repai,r./Rer,todel� <br />Valuation of Const`�ction $ <br />. i� G o c� � • <br />Signed IIy � ' <br />. For �. � � <br />Owner Pl�o�ie Z,sy-/uo I <br />hot I•:ritc IIelow Thi� Linc -I'or City Use Only ___ <br />�9�7l� ..... , .' Use Sone � . <br />� <br />?�9— ¢SL�; • Firc Zone ___ <br />Occupancy•Group _ <br />Typc of ConsLruc{:ion <br />Occupant Load <br />Sprinlcicrs Requircd <br />