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<br />. ! . ' , . . • DQILDINC PERMIT APPLICATION • ' ' ` ',. , .- ' • 'r�
<br />Z • ipplicant To Complete This =orm ' �/',����(%,'+
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<br />:=t oore than one buildinq is to be contructed, submit a sepazate permit applica- �
<br />.: t�On for each huildinq. 1► separate permit will be issued for each building. �,
<br />: � ' pner t%', f/ Lr /' fi�A /1 R 1 �SG : ✓ snilding Address � ��� � Z � /��<'%��'� G., : ..
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<br />. , ,�ddress J .h 2 / /l1h,V�C�/.'� f� ✓L_ Lot -��5— Hlock .
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<br />� �� City � �/ !t'L� TT Phone,�J�3 `1f//,� Subdivision (Plat) J"rN�!���«' G • ..
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<br />• '� ' Bcchitect/Engineer '
<br />_ •;��� `9� City • Pbone
<br />'; �. �iaatractor � � Z-�. .
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<br />_;•.• �ddress
<br />- :f! �Yty Phone
<br />..,.�:47 .: •i::, �
<br />`j;j State. License Ninaber
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<br />• : ' ;� . mcpiration Date
<br />� ':
<br />��' 'y � SEETCH PLOT PLAN BEIAW'
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<br />� . . . 3�. .� . . . _
<br />lfetes c Bounds (IInplatted) '
<br />Sec. ,� -. _ .�. �e --. -
<br />Bailding Use G�`/L l��`� � J "' ��
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<br />' Describe Work to Be Done ,��` .
<br />� � Gm,css �' G-.c�G f�e-,c-�,— � :.
<br />. � Qsa of Building ; .'
<br />• I��iev ❑ Addition p xepair/Relnoi,el
<br />i. �''� _• .
<br />• • Valnation of Construction S � �' •
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<br />� . , • .'! ' ' \ i : . !: r. �SUST/.c,�r ..
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<br />DO NOT H':iZTE BSLOM THIS
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<br />Date �eceived S//�/7 S
<br />Plan•C:�ec� yurber ' �
<br />_ �v-C% "�q
<br />Yalnation
<br />Pcmit' Fee c�i. � --
<br />� ' ' Ylan Check Fee �'�'�'
<br />, � Sbtal Fee Due �• `�
<br />� • Datc Issued ' � / ��� S� ,
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<br />. . � . : .. ,
<br />PLOT PLAN RF.QUIR£h1ENT5 ' � ' .
<br />. . , '.�
<br />' ?ndicate lot size, name of streets,
<br />•indicate location and width of
<br />• alleys, locate pr000sed and all ' �
<br />� lxisting buildiaqs, show distances
<br />to property lines, show distances .
<br />betWeen buildings. •
<br />Lot size x
<br />� Lot area Sq. Ft.
<br />Size of Bldg. Sq. Ft.
<br />ltumber of Stories •
<br />. Hasement
<br />Signed By
<br />For � � � � / _i. � - � � er7� . .
<br />� v Owne= Phone �
<br />D=e Zone
<br />Fire Zonc
<br />Occuoancy Grou� _
<br />Type of Construction
<br />Occupant Load •
<br />Sprinklers Required
<br />� .
<br />���FL, 14 C.- ' •.
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