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• . , • IiUILDING PERPSIT APPLICATIOid • ��� 7�n• .�. _ <br /> • 1►pplicant To Compl.etc This Porm �D � �//S/7,� <br /> l <br /> If more than one 'uui.ldi.ng i.^,' to be constr.ucted, subinit a scpar.�ite rer.mi.L <br /> application for each Uuildin�. A sep�irate per.ntit wi.11 be issucd for ench <br /> building. , <br /> Owner �, Ij7, �j�,J/�r�^ IIuildin� Address � 6,3 i, �("e �,r.1:X/�,� <br /> Address ��n ,,��c�6'�",�i/C" . Lot �`1- �, I Q� 131oc?: L�Z�_;, <br /> City � ��i�,���,_1� Phone :l S 3� ��X� Subdiyision (Plat) • <br /> Arehitect•/Engincer ,j `7f��P��_,L ��f���tr � i rJ • �-,-- <br /> City Phone Mete:; & I3ounds (lJnplatted) <br /> Cor,tractor ,.�A/y�� Sec. T�ap. ];qc. <br /> Add*_�ss <br /> City Phon� � , <br /> Statc License Number . <br /> Er.piration Date <br /> ' IIuilding Use �j� / _ � <br /> Describe [7or}: tn IIe Done <br /> C0;•PTW PLOi PLA27 ON REVE?tSE STI7� . — <br /> . • . Numb^-_r of Stories <br /> . • � • Basement <br /> � ' � " New � Addition RepaS,r./Remodel' <br /> � • . � Valuation of Construction $ �I�OQ �, <br /> , . � <br /> � , . . Signed IIy � <br /> ' . • For � <br /> , Owner • Phone <br /> _ ' Do t�ot i•7rite IIelow Thi, Line -For Cit-y Use Only <br /> Datc Feceived 3��Z�(� ' ' ' ' ' ' • ' Use Sone �- Z .Si,�K��; �` d*�� <br /> r-5 � <br /> IS].an Ctiec1: Number 7(o -!9/ ' • Firc 2one �3 <br /> Valuation rjiOC�D, Bv • , Occupancy •Group � <br /> Perr„it Pee •�O� � Type of Con�truction _` � � i � � <br /> 1'lan Check Fee !Q. �� Occui�a»t Load <br /> Total Pee Due ?3Q. B� Sprin)cicrs Required <br /> Datc Isaued • <br /> . . . CITY OF EVf_RFTT . <br /> � APPROVED (;OR F3U)LDINC; f'CfiMIT � <br /> �� Date / / gy� r <br />