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. . � . <br /> • DUILDSNG PERMIT APPLICATION • • 3c y ��� ' <br /> � . <br /> ' . Ap�liCant To Compl.etc T.hi.. rorm� ^��j � �/.�/J� • <br /> � If mose than one building i,� to be con�truct;ed , submit a separ.aL•e Per.m�.t <br /> � applicaL•ion for eacli building. 1► sep�rate peimit �•ri.11 he ZJJUCC� for. a�ch ' <br /> �iia���y. . /Gry _ <br /> Oaner Bui?ding Address _" <br /> Address . - - ;, < .� . Lot ?� /�T I31oc1: 7� <br /> City ' --% Phone Subdiyision (Plat) ' _ <br /> Arehi.ect/Enqineer �L'�� �~ '���� �� V •� <br /> City Phone __ Metes &� IIounds (Unplattccl) <br /> Cont_�ctor - • Sec. ��p. _ �`�e. <br /> ABdr�ss ' � <br /> City Phone ' <br /> State License humher � <br /> • ' • l�a <br /> gxpization Date i �. . <br /> ' • • � Building Usc � `� <br /> � Describe I•:or1: i:o IIe Done <br /> � � . . '� <br /> . - !�%i >i i /N <br /> : C01$'t.�:. PIAT PLl�N ON REVi,ILSE S7D^'u ����,.�,F: ;ti i:• �+ :. o r,�� <br /> � <br /> � m er�o�"�tories ✓ � <br /> - � • . Basement <br /> � , � • • • •• 21ew � Addition Repair./Reriolel' <br /> � . • . . � Valuation of Const�uction $ ". <br /> .. � . � , i <br /> Signed IIy <br /> ' � . For <br /> ' Owner . Phone .�'n . <br /> '' • � • Do Kot �4rite IIelow This Line -P'or City Use On� <br /> - ' • • • • • • � ' Use Sone ' � �` ' <br /> Date Reccived <br /> if]anChecl: NumUer • . . Firc zone _�_---- <br /> Valvation � _ ' • Occi�panc.y •Group . <br /> Pernit Fee • . Typc of GonsL-rucl:ion �_ <br /> Plan Chcck I'ee ' • Occupant Load <br /> Total T'ee llue Sprinlcicrs Required �_ <br /> Datc Isseied � ' � <br /> � . , • • • � <br />