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• ��: <br />• � , . I � r � -. ' ' BOILDING PERMIT APPLICATION � ' . . . • , ' :'•.'� /�i��1�/ . <br />" • t • Applicant :o Complete This .orm ' <br />. . ; � . s��'/� <br />, • If more than one buildinq is to be contructed, submit a separate permit applica- <br />..; tion for each buildinq. �1 separate permit will be issued for each building. <br />, � , �7`' O�mer � � � i ��E� G^ 8uildinq Address i �� �� �viG-C�f 4: �%� <br />. lddress 7 �� �-� %(./ /! r'�(�.//,/ � L�t � �- Block �- _ . <br />• ���'�� i SI.J- Ui�.;c- -"3�-� l T�-'r''L_• <br />. City_ . � � _ Phone - j Suhdivisian (i'lat) � +.-o <br />' � IIschitect/Engineer � � <br />• t.�� `•� �iiy phone Metes S Bounds (Unplatted) <br />' Contractor /'1?%C Sec. 'hap- R4e .. <br />- :� . . <br />' ' . . <br />` .' JWdress <br />' - ' �. <br />•'' City Phone Building Use ,l�.�r-P' ' "=�;�.,.., <br />• 'k� State.iicense Number Describe kork t Be Done i(_� �r�`"' . <br />� <br />� . . '� Lxpiration DatB � ' � �`l`��— <br />��' �� � � SRETCH PLOT PI.AN HELOW' • _. . <br />� ,.j ' . �. Dse of euilding <br />� � { � . . , ' ' � . .. � �New ❑ Addition�epair/Remociel <br />. .. . . : c��- <br />' ' " � ': _ ' • ' . . ' . • � Valuation of Construction S � G��� `-- <br />� ' . • . . � � . " - . � PIAT PLAN REQUI?t&�IENTS . � . <br />�..• . .. _ . . . '... <br />� <br />' <br />... -..�a ' •, <br />. ' <br />. . <br />� . <br />..� <br />.:. - <br />1 ' � <br />- DO NO': S�:tIT� SE: <br />Date Seceived S � 7 �� <br />•• ' Indicate lot size, name of streets, <br />'� •indicate location and width of <br />, alleys, locate pronosed and all <br />existing buildings, show distances <br />.�=i .. to property lines, show distances <br />• : betWeen buildings. <br />Lot size x <br />. Lot area Sq. F't. <br />' � Size of Bldg. Sq. Ft. <br />Number of Stories <br />easement _ � <br />� ., � <br />Signed Sy /-���/1=�c,c._-� <br />� � <br />� For ` J <br />� Owner Phone � � - � //["� <br />. i <br />r <br />Plan•C;�eck :7ur.,ber ' <br />Valuation ���- � <br />Yexnit Fee S ' �'� <br />Plan Check Fee '-'�� <br />. ' �.J^ 6 � <br />Total Fee Due � <br />.� / <br />Date Issued �'7 /%D/� <br />� . <br />'1 <br />O�e Zone <br />Fire 2one <br />Occunancy Grou� <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />. <br />6 <br />