|
_. � : ' � BUILDING PERMIT APPLICATION � � � �( t
<br /> - ,� . ' , �pplicant To Complete This ?orm /����/q' ��•j
<br /> , • S! more than one buildinq is to be contructed, submit a se arate '/�i" s
<br /> • . tion for each builciin .1 separate P pezmit applica-
<br /> 4• permit will be issued for each building.
<br /> • • Ormer .- "1'�-c/ -lrc' �� � .. �.Lr-r� Huildinq Address cy �-�: ;,, `,; " , .
<br /> , /
<br /> , -G- 7 OC Y"� , c <_
<br /> , . ]Iddress �- �C'.L— /I -:.-��x ,,,:r• o�- Lot / G Block / �' .
<br /> �. -
<br /> City � :. �'� ci� Phone �'-f1-,J=,�,? Subdi4ision (Plat) ' �- = � ' �/ �_ .
<br /> ' ' - i ) -; , � -
<br /> - Erchitect/Engineer .-. i,i�Y,r�. �:,.,� . . . . L�_ � -
<br /> - • . :..I s • =y, �' �. -. � � �_ , � i _ ,
<br /> _ -� City Lc ��r�i'ir Phone _=r��-�,s.d�' Hetes � Bounds (Unplatted)
<br /> . :, Coatractor . iC«c-c �� �% �c">�.. .L Sec. Tvp. gqe '
<br /> _ ' ' lddress C �i ,f �-L1 -_L'��c - � ' ' '
<br /> ', CitY !� .!� Phone > _ �. ,J__� ' . i
<br /> � �� -� Building Use �-� . -<��
<br /> �-i :,' -�'.
<br /> �;; � State License N�er � Describe Work to Se Done ` �'��,�
<br /> � : f Lzpiration DatE : � .
<br /> ��: � . ' SKETCH PLOT PLAN B£LOiJ� • -
<br /> . ' I . -
<br /> � � Qse of Huilding '
<br /> : I . .
<br /> -� . . ;� . , � �New ❑ Addition ❑ Repair/Remo�el
<br /> • � . , • � 'Valuation of Construction $. =�'� "
<br /> •,,,,• . , . . . � � � . . PIAT PLAN R£,�UI�.4IE:ITS . .
<br /> =
<br /> . . � ' - � • I�fii.cate lot size, nane of streets,
<br /> � ' ' indicati: locaticn anc width of
<br /> ' f - .. . • , alleys, locate �rogosed and all
<br /> ��,i _ existing buildings, sho:u distances
<br /> • �' � . � - � to property lines, show distances
<br /> � • • Letween buildings.
<br /> . � ' Lot size J,T X %✓�E, -
<br /> "' � , . Lot area Sq. Ft.
<br /> •:• Size of Bld
<br /> . � ' . � • Number of Stories Sa. Ft.
<br /> ' " ' 3. . • Basement
<br /> .:. .
<br /> • : Signed BY �F r (��r^ �. C��' C� .�_.�--
<br /> ; -
<br /> ' - £or
<br /> . Owner Phone �� .T.� .- •- . �
<br /> .' DO :�OT IiZT_T' IIELOFI TttIS LI:7E-20i2 CITY USE O.iLY
<br /> Da[e ��ceived 7/j/ 75 U:.e� Zon�� -
<br /> . — i o
<br /> ' Plan Chec;: )7u.:.ber 7S-Zg'/ Fire Zonc -
<br /> Valua:ion Occunancy Group
<br /> ' Peznit Fee Typc of Construction
<br /> Plan Check Fee Occupant Load
<br /> . : Total Fee Due Spzinklers Required
<br /> Date Issucd • � '
<br />
|