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BUILDING PERMIT APPLIC�TION / � �� � <br /> Applicant To Complete This Form ��3/7i <br /> If morc than one building is to 6e constructed, submit a separate permit ap- <br /> plication for each building. A separate permit will be issued for each build- � <br /> ing. , <br /> owner,/�f/ ,S�c� /�I"Y,-S-�,u Auilding Address �//O �t'n Jr rFe.Ltc��- <br /> —T— <br /> Address ,�/�0 /2oc/Cc� �=al�� � Lot2�i-2y II1k.y3G Sec. <br /> City�=vcve.�7 Phone Twy. Rge. <br /> Architect - Subdivision (Plat) oitt-v< �c7r — <br /> City Phone_ Metes & IIounds (Unplatted) <br /> Contractor,S�,v,NNa.v� �yu+�'��Nc'u f <br /> AddYess /.jpJ /-1Ncliccr� - <br /> CityE';�y,.�y/ Phone.313-° lZj' IIuilding Use <br /> State License NumberyZ-3 �a/ - YGGS Describe Work to Be Done C'eMcn� f <br /> , Expiration Date 1, - / - j� /����c /c I�U4/L�i+ 7�aiv d <br /> � ' C�tiYc.c J� �'<�oiv� 5�7� ��S <br /> Use of Building <br /> � . New . Addi.tion �pair/P.emodcl <br /> � � Valuation of Construction $��J� Za!� <br /> . PLOT PLI�N <br /> i <br /> �'���� Indicate lot size, namc oE streeta, <br /> , � �/� C�` y, indicate location and �aidth of <br /> �1ivKa /3t/rS alleys, locate proposed and a17. <br /> � � existing buildin9s, show distances <br /> L'�,�1,�y ����r�s to property lines, show distances <br /> � between buildings. <br /> � �� ` // �.-4tLe y '//i' .�NCL <br /> Lot cize x <br /> i� Lot arca S.F. <br /> ____ Z- � /�'� �jH f /va�.vy Size of 131dg. S.F. <br /> �y.R-� Numbcr of Stories <br /> � /(�"/_�+����9 llasemenL <br /> � �,� ��,_�, �L_ Use Zonc <br /> , q, , <br /> — - ----- --- Siyned Dy1��. < .�.�� <br /> iM ' <br /> For <br /> otoncr <br /> DO NOT WRITE llGLOW T[I'3 LINli-POR CITY USfi ONL�Y <br /> Uate�Received�� �j I'7 �� 1'ire Zone <br /> Plan Check Number � Type of ConstrucT.ion <br /> Valualion Z S�C�-v`- Occupancy Group <br /> PermiC Fee `�=`,-. �� Occupant Load <br /> Plan ChecA Pee � Sprinklers Iicquired <br /> � ToCal Fce Uuc 21�. �� <br /> Pennit Number �Q�j�i'Q- <br /> Date Issued ��� ?,I-/ j � � <br /> T <br /> A�'P�����P FOR CtUtLDING PERMIT <br /> �.ao�__-�v-- .--_ <br /> , <br />