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� � BUILDING PERMIT APPLICATION <br /> � Applicant To Complete This Form <br /> � If more than one buildin9 is to be constructed, submit a separate perruit ap- <br /> plication for each building. A separate permit will be issued for each build- <br /> �wner ��y�-'"�� C."{.�� �� �uilding nddress t%'(o'�T� CYY�✓/��/C' ��� <br /> 9dress 4�j�)Z•��� � Lot_� �lk.,� Sec.pl�. f� Z <br /> City��F��LI P}�one��O�T�'�P• Rge. . <br /> G� J��Subdivision (Plat) <br /> Architect �P"�j Q — <br /> City ��1�� Phone�_"�j4 Metes 6 llounds (Unplatted) <br /> Contractor OIJ�jG'�� <br /> Address � ��� �f <br /> .�f� J <br /> City �" Phone uildin9 Usc <br /> gp 2sZ- ��3� Describe Plor}: to IIe �w:c ��I.�L.1' r�s�,1F� <br /> State License Number <br /> . '�'� <br /> ��s� . • <br /> E�:piration Date � `"'T'�" ��' t�� P��i�� <br /> . Use of Building <br /> xNew _ Addition Repair/Fenoc:cl <br /> �� <br /> Valuation of Construction $.��L � <br /> PLOT PLT1� <br /> � Indicate lot size, nane of strcet's, <br /> indicatc location and �:idth of <br /> . alleys, locate proposed and all <br /> . existing buildings, show distances <br /> to property lines, shca' disCances <br /> bettaeen buildings. <br /> Lot size�_x �1� � <br /> � Lot arca S•F�• ', , <br /> � Size of. Uldg. '1�' � I • <br /> NumUer of Stnrie__ _ � <br /> llasement <br /> Use Zone <br /> , Signed Dy � ' <br /> For �*.��T � <br /> owner I <br /> DO NOT IiRIiG IIBLOl4 TIiIS L7NP-}'OR CITY USF. ONLY � <br /> � .� j <br /> Uate Reccived ' ! - � Firc Zo��r�. <br /> Plan Check Number • '-] `-�_ Type of Constroction � V. -1-1 <br /> . Valuation __�,�-�W �:,<� Occupancy Group �_ <br /> Pcrmit I'cc iq-� J-�� Occupant Load . <br /> � � <br /> Plan Check Pce `ih"• i'� Sprinklers Required <br /> Total Fcc Uuc 'i,3 4 c.� �� ��� '' � �-�'•'�RETT <br /> Pcinit n�mbcr ' �qPPFOVLD '- ��R f3U;LDIfJG P�RMII' <br /> Date issucd Doic-� ______(�y _ <br /> ��f'f�Ob'�D FOR L3UILDII�G Pf.RA11T <br />