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go <br />.- • F BUILDING PERMIT APPLICATION �^ •`/ �..� - <br />Applicant To Complete This Form <br />If more than one building is to be contructed, submit a separate permit applica- <br />tion for each buildiing.1J A separate permit will be issued For each building. <br />Owner Building Address <br />Address �0 \'k `MRUA-bb� FRNr-- Lot �' \y \` �r ="Block �33 <br />City �=V1 �C=�T Phone�i5'�-�\\h Subdibision (Plat) �•��KD�IE�✓ ��Dl� <br />Architect/Engineer <br />_ •;�+ . `'� City Phone <br />\— <br />.,' Contractor )kw oRO <br />Address �°1�r•�\� �1iC �M08i� <br />City V�VEFr �1 Phone \5_ti\A <br />State, License Number <br />!fetes i Bounds (Unplatted) <br />Sec.-- Twp. Rge <br />p � <br />Building Use 1,ES\mC ozy�- <br />Describe: Woz-k to Be .Done <br />�i Lzpira,.ion Date ���'C�- '.°lr\� - �PI''���. •��r�'41\St= t1ooF_ <br />a'd <br />Use of Building <br />❑New ❑ Addition b Repair/Remo:iel <br />•' � Opp <br />Valuation of Construction <br />PLOT PLAN REQUIRE}ENTS <br />'S <br />Iirdicate Lot size, name of streets, <br />-indicate location and width of <br />r.1leys, locate proposed and all <br />existing tuildings, shcw 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 />Number of Stories <br />Basement <br />Signed By <br />For �// <br />VIIY E Qi1K�1 <br />Owner Phone <br />DO NOT WRITE BELOW THIS LI'_- FOR CITY Ube <br />Date Received <br />Plan Check Number <br />Valuation <br />Permit Fee = <br />Plan Check Fee <br />Total Fee Dua <br />Date Issued <br />Uce Zone <br />Fire Zone <br />Occupancy Group <br />Type of Ccnstruction <br />Occupant Load <br />Sprinklers Required <br />