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i .�. • , /I'' ;� <br /> , � DOILDING PERMIT APPLICATION � c� ���/ ,:��� • � <br /> - � ;' � ' , � �pplicant To Complete This ?orm // '�����s .• � <br /> , • � It oore than one buildinq is to be contructed, su!�mit a separate pecmit applica- <br /> . tiop fo= each buildinq. 11 separate permit will bc issued fot each building. <br /> � . . O�mer ��-(? cp/-�L�I�•r l%a ���i_�/1/��J• Huildinq Address �.' 19- ,��-/���P��/v� <br /> ` , uaress�.1�.9 /26c%l �- �=r i/E i��rae �=��> i�� 91ocx !77 . (� . <br /> 1L- , n r <br /> City � J�� F' � Phone .1 '{ �,��Subdivision (Plat) ��. If��'� �� 1/� f O f= <br /> , • xtchitect/Enqineer �— � l </9 � -1�-Jc - ��-f �-/ y y'- rr_ i�-r /�• <br /> `"� City ��ph eo e Netes G Bounds (Unplatted) <br /> t � r� .. <br /> � :,� Contractor �-c yJ ,p J �r u�/�'i2��"�Sec. iWp. � Rge ' .. <br /> : . . � �ddzess �, �/�� . � i� C c� • . . • <br /> ! CitY �✓�,.�,,..�„ r� Phone -Z � Buildinq Use t FLS . . =•: :�;' <br /> ��-� . �: , , : <br /> ��. � �-y� � State_iicense :Iumber o? 1 ?�o i ?c��.�J Describe Work to Be Done �`�'�`��'�. � <br /> • : ,I E�cpiration Dat� ' V� ,?d( /;���,, ' <br /> -\ : '" . SICETCH PLOT PLAN BELOW' • T - <br /> . . • . � � . . � . � . . <br /> � : � / �-----� IIae of Buildinq f� .,J ' <br /> � � !��c� f \ •/. . . . �Nev ❑ Addition Q Repair/Remouel <br /> � . .• .t • � . . ' � . . � <br /> s . ' • � . • 'Valuation of Canstzuction $ �OD `� <br /> � ' <br /> �`.• , . � • P2AT PLAN REQUIRF.�LENTS S �� � <br /> � �. � / �i� .. . � . . �.; . <br /> ' Y �� ' • Indicate lot size, name of streets, y <br /> � ' ' •indicate location and width of <br /> � /� . ' alleys, locate nrc.rosed and all <br /> � :�� /G ��� /�'�-�� . exi.sting buildinqs, show dis:anc��s � <br /> ''" ' '' "! " = to property lines, show distances <br /> � ' � � . • betaeen buildings. <br /> ' � � ' • ' <br /> , Lot size x <br /> �•' ` Lot azea Sq. Ft. <br /> • � --' �� • � � Size af Rldq. Sa. Ft. <br /> ` � '� Number of Stories <br /> • ' ��: � i� /� . Sasement , <br /> •:. . <br /> � ., �- bigned Sy e .�� .�� � <br /> . ; . f"I 9��' . <br /> ' - Fos <br /> � Owner Pho e <br /> DO NOT {i:iITS DELOS9 THIS LZNE-POR CITY OSc OiiLY � <br /> Date Ceceived Oce �one � <br /> ' Pl�n.Gzec:: :Jur.,ber ' Fire Zone ' � <br /> Valuation Occunancy Grou� _ <br /> Perait Fee �- Type of Construction � � <br /> Plan Check Fee Occupant Load <br /> . � Total Fee Due Sprinklcrs Required <br /> Date Issued � � . _ <br />