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. , � �= <br />. HOILDING PEAMIT APPLICATION . _, <br />)Ipplicant To Complete This ?orm / '•�✓� _'7 <br />/ <br />� If more than one buil�iinq is to be contructed, submit a separate permit applica- <br />tion for each building. A separate permit will be issued for each buildinq. ��� / <br />=� � Owner ����r ,��i.LI�/ Buildinq Address ,?�i,; /%J�/Jdtlor/.��1 <br />_ 1lddress rr �!. i /I"� �/)c �.c l•;.�,1� Lot 7 `Y � Block �f %'!; /)- ^n_ <br />City ,��l.ai4,irr Phone ot,�� -/` �� � Subdivision (Plat) <br />llrchitect/Engineer <br />'� City Phcne Hetes s Bounds (Unplatted) <br />. : , Contractor ���'�Lia..C' 2i � Sec. 1Wp. Rge � � <br />/: � • . <br />l <br />' ' �aIC35 �".J ( � ��n���-i� :'r' — <br />�' � <br />' - � <br />City l �=c-,rZr' Phone �h ..T Building Use ���._ti. �( ��� . ,- •� . � � <br />� r ' � [/ <br />�� . ;:� SWte License Number Describe Work to Be Done ;��zex-�--Cl�% .����� <br />, . . . i E;piration DatE ' ����'C' /��-�h-�:,ry� f''r-�.-��.- . <br />SICETCH PLOT PLAN BELOW' <br />N <br />A <br />� �;��� - <br />� `�Dae of Building ��!Z��c.r.�-,-- <br />❑New ❑ Addition �Repair/Remoc;el <br />' cv. <br />� Valuation of Construction $� %.� Z��� <br />PSAT PLAN REQUIREMENTS . . <br />Indicate lot size, name of streets, <br />�3ndicate lcca:ioa and width o£ <br />alleys, locate proposed and all - <br />Cxistinq buildings, sho�a distances <br />to property lines, show distances <br />betveen buildings. <br />Lot size � �� x /.�C <br />Lot area Sq. Ft. <br />Size oE S1 g. Sa. Ft. <br />tlumber of Stories - i <br />Basement t.� : <br />,� �-� ' <br />Signed By ��; , � : �f ' ii C����' <br />.� For . �/ _ - .-�� <br />Owner Phone _:5.�.' � <br />DO :IOT Sti:2ZTL B�LOFI i}Si5 LZ <br />�f � <br />Date �eceived y- %`�� <br />i <br />Plan. Check :7ur.,ber <br />���: <br />Valuation � �j��C:' � �— <br />Pexnit Fee � ��`'> � � � <br />Ylan Check Fee - -- <br />G (, �.= <br />Total Fee Due � C_� - <br />Date Issued <br />Uce Zone <br />Fire Zone <br />Occunancy Gxou� _ <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />