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' . , BUILDING PFRMYT APPLICATION / � �OZ/ �'i <br /> -� : � Applicant To Complete This ^orm ��/�� <br /> •If more than one building is to be contructed, submit a separate permit applica- /7S/ <br /> tion for each buildinq. A separate permit will be issued for each building. <br /> Building Address �' c_ 1' �-�'r^�:.�•=�" ��''z� <br /> Ovner �;.� i- �' � <br /> <�. �t B1oCk <br /> 7Wdress ia Jr � f l�oa2 L�.,=� <br /> � � � �, Subdivision (Plat) �l71 '� ��- LA•>�-M��,� <br /> C1ty �t n 1��s r,W=� phor•� �Y,��7 74 <br /> AzchitectfFngineer r-+�.•��� <br /> • � City _ '� Phone �_ Metes 6 Bounds (Unplatted) <br /> Sec.�_ '�'P• " � R9e � <br /> Contzactor C �A���=•� ��^-'�•' �`�`-. � <br /> Address L F 1 L. 2 . \L� ti- � <br /> City F��-�%t� ___ <br /> Phone 2`�`I 3 'Y..,-� Building Use �,�,� � c•'�-'•��- �?£^�+tr.� <br /> ' State License Number 'Lz3 <br /> _�,Z -�-�21 Describe Work to Be Dene R- � � ' `cv��-J'•"� <br /> ' P�1 ���` t�Ixi. >c�t n �\ 3_�a.�rt. ���- <br /> �� Expiration Date -� _ <br /> p\�.•,...:.: .,�. �.-��r��,�,_r �1�,�;vr. <br /> � SRETCH PLOT PLALI BELOW� ' , <br /> • ' IIse of Building �?�� � , a�N��-� `;{'�'�` <br /> ' � ❑New ❑ Addition 0 Repair/Remodel <br /> � un <br /> \ ' — <br /> � ' ' Valuation of Construction S ('�_� <br /> � . � .� YIAT P7,AN REQUZREMEtiTS <br /> -�.. • . <br /> Indicate lot size, name of streets, <br /> � � . indicate lo�oPio=oap5eal�na all <br /> • - . alleys, locat_ P p show distancee <br /> � • � existing build�ngs, <br /> � . ,� . to property lines, show distances <br /> . • . between buildings. <br /> _ � <br /> Lot size X <br /> • � ' IAt area Sq. Ft. <br /> �- . Size of Bldg. _ Sq. Ft. <br /> � ... - Number of Stori=_s <br /> � Basement ,� <br /> . ' ��7 ` ,.51.� ._..�� <br /> . .. . Signcd 3} � — .. <br /> • :c�� • <br /> For h z � �^ { <br /> . . owner p � -.�1-�' <br /> p0 t�0: F�:ii'_� �-��'•' �`•�+5 �i?J`c-FOR CiCZ USE OiiLZ <br /> Date ".�ceiced U:,e �one <br /> c^:re Zone <br /> �1zn C:�c��}: Sur. c:;� -- <br /> Vaiva:ion Occuoancy Group _ � <br /> Pemit £ee _ Type of Construction _�— <br /> Plan Checl: Fee <br /> Occupant Load — <br /> Total Fee Due Sprinklers Required <br /> DdtC ISSU^_t� <br />