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• . • • � . <br /> . , ' IIUILDING PERMIT APPLSCATION • . ��a_ 7f� • <br /> � • ' Ap�licanL• To Completc '�hiv Porm ' � �C�f� <br /> I f m oze t h an o n e b u i l d i n q i,�t o b e c o ns t r u c t c d, s u b m i l a s e p a r.a t e p e r. L/f�� <br /> application for cacl� buildinq. A scparate pernti� �ai.11 he i�� • �,d L•o�c cach • <br /> building�.�/ / � <br /> Owncr %J >�,-, ( ,,�,a�f%-��/fiZ% Building Address � � .11;_'� _ <br /> naar��s 3 2. f%� � �����_.. � �-z,�:_. Lot �3 nlo��: <br /> City Phone 3 s�•�'y.�p Subcliyision (Plat) �; ,.z�,� � <br /> Architcct/Engineer � i!/ �O /. <br /> City Phone Metes & IIound� (Unple�tt�ci) <br /> Contrect•or �,,,�.,, �� Sec. Tcap. Rge. • <br /> A�dress <br /> City Phone • <br /> State License t�umber . <br /> Er.piration Date <br /> /) /� <br /> ' . • ' Builcling Use (3 ,�,���;.,r,.-�C�. <br /> • � Describe S9or}: to IIe Done =��� <br /> � C01^��:� PLOT PLA11 02i REV�RSE SIDli �,�"""-`��� <br /> Number of Stories <br /> . ' . Basement <br /> • � . ' � " Nec•� �ddition Repair./Rer�odel' <br /> . • ' •.. , Valuation of Const�uction �/D(�, <br /> _ .. . . � / r•, <br /> . . . , Signed By ,✓�..� -� , iiYi .- . .�,�� <br /> . . For <br /> Owner • Phoiie <br /> • � Do 2:ot ��;rite Delo�v This Linc -Por City Use Only � <br /> Datc Reccived • " " " • �� Use Sone � • <br /> IS].an C�ec1: Number ' • • Fir<: �one <br /> Valuation � ' • _ Occupancy •Group <br /> Pernit Fee � . Type of Construction ' <br /> Plan Cl�eck Fee ' • Occupant Load <br /> Total l'ec llue Sprinlclers Requir.cd <br /> Datc Issued • , . <br />