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, 1� !• �' <br />� �; � <br />, <br />, <br />, � ;' <br />BUILDING PERM7T APPLICATIO� <br />Applicant To Complete This ^orn <br />If more than one building is t:o be contructed, submit a separate permit apFlica- <br />tion for each building. A s�parate permit will be issued for each building. <br />Owner �. {}+tl7iE �I%C� 0- �/. 5 o n% Building Address !SZy a''� C`1�-j UC�. C�Z-- <br />aaaress /s.�� ✓r,r�,Do �����. A��. Lot �.y� x� s sioox 3/� <br />City �(r'�%Z�'}�l- Phone '��'�,2_ L• 9Q� Subdivision (Plat) ',e'-n.`..��,�r-1aJ <br />�— <br />Architect/Engineer /.� �.�.�a-,�, � ��L=t� <br />Cit� <br />Contractor <br />Address <br />Phone <br />City Phone <br />State License Number <br />Expiration Date <br />SKETCFi PLOT PLnN BET,OW <br />�—,Vd J�, <br />dE, <br />P4etes & Aounds (Unplatted) <br />Sec. 'Iwrp. Rge <br />Building Use <br />Describe Work to Be Done �i}-yL2�.ct.c�, <br />..-.._� /T'UiT�"�rr�- _ <br />Use of Building <br />❑*lew ❑ Addition ❑ Re�air/Remodel <br />eo <br />Valuation of Construction $.�O O `� <br />PLOT PI,AN REQUIREt•iGNTS <br />� Indicate lot size, name of streets, <br />'� indicate location and width of <br />� alleys, locate oroposed and all <br />existing buildings, show distances <br />to property .lines, sho•� distances <br />between buildings. <br />Lot size _x <br />Lot area Sq. Ft. <br />Size of Bldg. Sa. Ft. <br />Number ef Stories <br />Basement <br />S�gned By <br />For <br />Owner Phone <br />Pp plpm �;nrm` ��LCi4 TFiIS i.I:1�:-F0.^. CITY JS� OiiLY <br />Date Rcceived /�- � ��` Use Zone <br />Plan Check �Iumber Fire Zone <br />Valuation ��O ��— Occuoancy Group _ <br />� � �z� <br />Pcrr.iit Fee �� Typc Of Censtruction <br />Plan Chec': Fee <br />Total Pee Due <br />Late Issued �/ "/' �/ <br />` _. ' ���. /�--4�-- 7 � <br />��' t .�� <br />Occup•�nt Load <br />Sprinklers Required <br />.:=;- <br />e <br />e <br />