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'R1dMl5it;:;-. .. � <br />' • BUILDI\G PliR1-0IT APPLICATION <br />/��:�i <br />Applicant To Complete This Porm �� -� / <br />� j ��%� <br />If more than one building is to ne constructed, submit a separate permit ap- <br />plication for each building. A eeparate permit �eill be issued for each build- <br />ing. <br />Owner i ���iTlorJ/a� 1-1u.ri •L= S <br />Address2.i ��IGtt�'�IpFi- n <br />ZS.:.- 04�?/ <br />City���fzr:"r7- Phone L;�s 3,U\ <br />Architect ^�(jn(,� __ <br />City Phone <br />Contractor ��2QbiTI�AlAc, NDt�i � <br />Address'Lll t: y��.�c.� �IOF.� r�=, <br />. �'i Z. SG9/ <br />City L'ULEi.T1- Phone 2S4 3J-// <br />Bui lding Address 3 Z3 'eZaCK cF 1=1.L'=� :' <br />Lot12 . 1 Blk.. S`i Sec. <br />Twp. R9e. <br />� <br />Subdivision (Plat) �L�, O!✓. ��• <br />Metes & IIounds (Unplatted) <br />Building Use ��t: S (Y]r_-/��.Tt/i �- <br />State License Number TR{4{IO-it�L4.P'L Describe Work to Be �one A�V tJ <br />Expiration Date ���, i-IbiU - C?ilnl4yj�uC i 1��.1 <br />b0 N07 <br />Uatc�Received �� I? <br />Plan Check Nmn6cr �7 <br />ValudLion 2.S d.� f <br />Use of Uuilding �.�,�5 <br />New Addition I:eyair/P.enodci <br />Val.uation of Construction $ <br />PLOT PLAN <br />Indicate lot si2�, iun�e of streets, <br />indicate locaCiuc and �;idth of <br />allcyc, loc�te proposed and all <br />existing buildings, show distanccs <br />to property lines, shov dist�nces <br />between buildings. <br />Lot si.ze Si� x_L3�? <br />Lot area S.R. <br />Size of Uldg. �; gµ S.P. <br />Numbcr oP Stories T <br />Basement <br />Usc Zonc <br />r <br />Signed DY� `���, � �. " !l�l� <br />v <br />Fo�:,-7 ���7�i. . , � ' /%, /7s, �s . <br />��. <br />Owncr <br />' Fire <br />Permit- Fcc // y � 4'-V <br />Plan Cl�eck Fee ���, ��� . <br />Tot11 Fee Due / 7 � , �Z"� <br />Ye!:mit Nunil�er <br />DaLc Issucd <br />USli ONLY <br />Type of Construction ��� � f � <br />Occunancy Group <br />Occupant Load <br />Sprinklers Requi <br />FlrHr,ov�p roa Quu.n;rvc p�izn�ir <br />Date=�-�-�_i �_. ._Gy-'�-- <br />