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•• . ! . " , . • Dd2LD2NG PERMIT APPLZCA2ZON . � `..j .' �: �,,,ccc��� i' �
<br />"r• �• ! • � � , � �pplicant To Complete This :orm ' :�� .� �
<br />�• •�` It more than one buildinq is to be contructed, submit a separate permit p� ica`
<br />� .•; tlon for cach buildin�. �1 separate permit vill bc issued For,each building.
<br />. �,�OMO!! L-�.Pl'P'J��i fiif.11�vaoi '/_-ii(� Eaildinq Addres! ,/`�.�C� �%"c�r t�d,i.' .
<br />' . .� �Edsesa ///�71? i% c�v-i�d n LOt Block ' .
<br />.•' City l_r ix/,� Phone �'LSi' 3//% Subdi4ision (Plat) •
<br />• , � .
<br />� �ichitect/Enqineer • • • ' �
<br />_ •,'�� : .`_'i . Citp • Phone Netes i Bounds (Unplatted) ' •
<br />. � ;,• Coatractor '%�)i'�t'� ���",�s�i-�., n tie,t Sec. / � �iVp. �i� RQe C]�j .
<br />' ' �, • �• Mdzess i c 9c,f ; � �,�. �,• /n/ G.;, . . . ,
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<br />. .� 1 City h. e„• f! . G�'�� Phone :i5 5- � L� % Z- Snilding Use �� �� r C' P '�"`: :`-"' �
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<br />•- ��� State,License Na�cber Dcacribe Work to Be.Done �u �n,`�
<br />/ . _��...
<br />� . . , �I fspiration Date • �- L' �< C� Y c �,F .,� � � �
<br />�.�' ' • • SICETCH PLOT PLAN BELOW' • •
<br />; f ; � . . ' . . . . , .• . • Qse of Buildiriq /��: p P
<br />• ..
<br />�• i ' . ' ' � � � , •�Ae�► ❑ Addition ❑ Repair/Remo�el
<br />� � `'�. ' , • •• , ' . �• • �lfnluation of Construction $ � •
<br />• '� • • .. •• .. ' :
<br />�,. • • + - . . . ., .. � PlQT PLAN REQIIIRE.tIENTS . , -
<br />1. . . . ' ' ' • . . . . . • . ' . ' A
<br />� :. ( • • ' � � • , • . • ' indicate lot size, name of strcets, �
<br />� y• ' �� . '� � - •indicate location and width of �
<br />. � ,� � • " � i'.: ' _ •j•� � • alleys, l.ocate proposed ar.d all '
<br />• �•�� , � ' '� � �' ' • existing buildinqs, sho:a distances
<br />, . � �. .�:^� � -• -- � • • • . ,~'+ � . . to property lines, show distances
<br />t • � � . • . between buildings.
<br />i. � • . . . _. , • . . .
<br />. •. . . t. .. . . , ' �. .� : Lot size x � ' ' —
<br />� ia= . � • . . • . , . . Lot area ' Sq. Ft.
<br />' . r. : . . �: • . Size of Bl q. � '}{ Sq. Ft.
<br />• ' �'i '. . • . • Number of Stories Oy7 '
<br />:, j� . . � . � . . • ' • ' ' 8asement iy,'D �v-L- � :' • .
<br />• '..�-- � _
<br />`�1,. . ' . . `, . Signed By ���� ����% �.� �rL .
<br />1.� . . . . . . . . � MGeT�n/ ' .
<br />.. . . . . . • .. �For
<br />Owner Phone �.s 4 - 3i/ %
<br />.. � DO :70T 1C:YIT� BE
<br />. � Date �eceived �"Z�?-��"7�
<br />. . - . —T - _
<br />' Plan Chec;; :7ur..Ser 7 ;_; -�{-S�o '
<br />.' valvation l%��� 2, �
<br />. . . • Petnit Fee �Z. � ,
<br />' 81an Checi; Fce ��Cr• ���
<br />' ' ��
<br />, •, � ibial Fcc Due � n • ��
<br />Datc Ir>sucd •���!'/74�
<br />' �'. • ... ��-' . ,• .
<br />7E-20ii CITY USr^. 02IL'I' � .
<br />IIsc• Zone � M- � , i-�vY +��+. , �
<br />Fire 2onc � ' �
<br />Occuoancy Grou� �� � - L
<br />Type af Construction SL - t-1 - •
<br />Occupant Load
<br />Sprinklcrs Required ' �
<br />.. . . �1TY. OF �VEf�ETT
<br />AP.PROV[D'FQR.,�UILDING PERMI•T•
<br />Date �� Z�3V:•' ,L�y• � .�L . . .
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