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<br /> ' } "� ' ' ' 9UILDINC PERHIT APPLICATION � • . . .. ... '�.��.V-• .;�•'�''
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<br /> - ' •' • ' , , • : 1Lpplicant To Complete Thi� :orm �/�� ,���f/.,.� �
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<br /> , • � Z! nore than one buildinq is to be contructed, submit a separate permit applica-
<br /> . ; tion £or e�1ch buildi r. A separatc permit will bc issued tor cach building.
<br /> . . � ' O+rncr r J /�/�j'� Euildinq Address ��`�� �(„ �� �(1 p � ; �
<br /> .' • � lfddress • � P ) LoE'. , 5 J � G. H2ocY, L-�j�� ;
<br /> . . City�\(Q�RU }CY. Phon _ ? 5ubdi43sion (Plat) ` � ` rp ��. '
<br /> ' ' Azchite t En ineer � ' d�.A" 1 , �I(�, � , t • ' •
<br /> � 9 r, 11P ) -Q-(�'�
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<br /> _ `:i :�. '_� City �' Phone \ Hetes s Bounds (IInplatted) ' •
<br /> � �a /��
<br /> :�'. Cantractor .l �Q�Q v .Y � lU'1'Oh,� Sec. 7top, Rge . '
<br /> _. � ;• �_;� �aar �s �'�,f�, 4 � �o�mnoo�, I ��c �,� _ � _ . . :
<br /> .. 't: City� �� -� Phone 7-- f � Duilding Usc ' ' '=�; '• �
<br /> • � ..�:
<br /> � {� � Statc Licen^e Nc�ber ' /^ • . • .��''';..
<br /> �.j . ���-��-/���F-�1� Descrive Work to Be Done
<br /> : . �I E�cpiration Dat� �- � =� � � � I�Q ) , `
<br /> �� ' � • • SF.ETCH PLOT PLA?1 BELO;P' • �'� �
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<br /> � � . j••. � • .. . , . . . ' , • . � :
<br /> Ose oE Duildirig
<br /> �� � , � � . . .,. ' �Hew ❑ lu3dition ❑ R�pair/Remo;:el
<br /> . . , ' • �' _!__`1._
<br /> � �� " . . •: � 9tiluation of Construction $ (�
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<br /> � � �', ` - -��� :� .-.. � �, _ .. = . . . PLOT PLAA1 REQUIS2E}L:ITS . ' .
<br /> � . . . . �.`y
<br /> .. � • • ' ' , ' . � • Tndicatc lot sizc, nane of streets, � j
<br /> • • . -. '' ' _ '_ _ � ' ' •indicate location and width o� _
<br /> _ �• � .. _ _ alleys, locate proposed a.^.d all
<br /> • '': . • . ' ' • existin buildia
<br /> . . � • • • ' ' . . . . . g 4s, shc:o Zistar.ces
<br /> ' - '- 'a • ' '� ' to property lines, show distances
<br /> , • � ; • : � ' - betwcen buildings.
<br /> . . ' . , . - �. . . � ' • ,
<br /> � ' �•• , . . • . . : Lot size x •
<br /> � .. . � � . • ' - ' • . . Lot arca � Sq. Ft. �
<br /> . r, = . . .. • � Size of Bldq. Sa. Ft. ,�
<br /> � '� , • - ' Number of Stories
<br /> • :: . j � . . . . � . .. • ' ' ' , Sasement � .
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<br /> '� : . ' . '. Signed By .
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<br /> • '_ • . For
<br /> .' - • Owncr Phone
<br /> .. ' � DO VOT KZ?TF. �3'c:.007 TI{SS LI:]E-cOZ CITY U5H Oi7L'L ' . .
<br /> . Datc Seceived � U�e• Zone •
<br /> ' Plan C:teck :7ur.,ber � ' Fire 2one '
<br /> Yaluation `-��j� , �-'� Occuoancy Croup
<br /> Pemit Fce � ' Type oL Constrnction
<br /> Plan Check Fcc Occupant Load •
<br /> , � Total Fce Due Sprinklcrs Required ' .
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<br /> Aatc Issucd ' , ' . .' , . .
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