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` ; �„'-:•-.t ;.�. ..i.�: <br />_ � .. � . • ' ' � HOILDINC PERMIT APPLICATION . . - -- ;. -.!'j_.. .. �� <br />„ , . , , � Applicant To Complete This i'orm ��CI�''��c/ �� � }. . <br />%/-'-��%S';• <br />� •` Z! more than one �uildinq is to be contructed, submit a separate permit applica- <br />. .. t1oA for each buildin�. A separate permit will bc issucd Por cach building. <br />• ; � Ovner ' f�/•ri� � (:�• �����L.F Duildinq Addiess � ���>> j�t�(�Y_'f f-CLc_t;�C_ <br />r . � . .�_ i <br />, �� <br />, , • . 3ddress �:� . c'3—S �l:.c. Lot_ /i , i2 Blak ��� ; <br />. City ���1%)2� St:'/LC�hone lri�/-ri%/`� Subdi�ision (Plat) c�%- -�Jz� �/ ,. <br />_ � � kchitect/Enqineer • /J! U ��l%�� . . , , <br />�- � i . • ='i �tY • Phone Metes i Dounds (Unplatted) ' <br />;.. . . _ . � , ,�� ' <br />- :�'. Contractor _ -4' � ' Sec. Syp, gg�, , - <br />. ;• : �• 1Sddzess ' _ _ , ' ' . <br />• � atY Phone � ' / � _ '— : � <br />�_i Duilding Use �cs'1Nr h'K'4'�;c— "". ` <br />. -5.'. <br />: � r: ' . /) :: <br />r State,License N�aber Describe Work to Be.Done �F'.' <br />: . �i Ezpiration Dat� • _ �l'- KCC 1 (�'� /�J %G_ p-� �,�� ' . <br />L�' � . • SICETCH PLOT PLAN B£LO[P' • - <br />. J �; � - � ' . . . � .. • Ose of Buildisiq ' ' • <br />�� i � ''�: �•=.•' , � •�New ❑]lddition Repair/Remo�el <br />. . ; • �- _•;--'.--.- ._. • ' •.' • - - - - � � <br />� �' �(�1,�-'C . . � • i • Valuation o£ Construction $ ���% � <br />N'� . ��-.. _��,�•• ;. . � <br />„ + - •� ,. ; -. � ^ � . PLOT PLAN REQUI?tE7tE:ITS . : � . <br />� . , . � . . =� <br />.• t .' ' � ' ��. '�• � ' • ' ' Zndicate lat size, nane of streets, <br />• _• � : , ._•, : . .. � ' ' " 'indicate location anc? width of � . <br />j ' ��,"�' ' '� • alleys, locate or000sea ar.d all <br />_ , i�!1 . ..;^r,': �- \yr-.^ . .` � •' . ' �isting buildir.qs. sho:a distances <br />� '' to property lines, show distances <br />+..� ' �. � � _ 6etaeen buildings. . <br />. . ' . . V . . . . . e <br />• .. �: , . 7.ot size x ' <br />. . :.• -. .' , . <br />• S•`- � . . , . Lot area ' Sq. Ft. <br />. . �' r. '. • I ..�i � • ' • . Size of Sldg. Sa. Ft. <br />� ' — --- �--• ' ' Number of Stories <br />' � � ': • � � '7 � ^ " � ' basement <br />, f •..� - a�C���GG-F�l���rZ _ _ _ • . <br />� -'' � � • � . . � Signed By �L7 �.{�,.' � <br />. �.: . • � ,• . • ' For --� y � <br />. - . . Ownez Phone <br />..' ' DO :IOT Si:iIT� ➢�:.Of4 T}iI5 LI:7E-F02 CITY USc OiJL'! ` - <br />. _ Da[e S�ceived �� Z v "j � �� ' ti�e• Zone • ' <br />' P2an Chec:;.:7ur.ber ' ' Fire Zone • ' <br />Ces; . <br />• Valuation % � �; Occuoancy Grou2 � . <br />Peroit Fee ' C� . �=c:.�.. - <br />Type of Construction • <br />' •Plan Chcck Fee �� Occupant Load ' <br />' � c� — <br />. Total Fee Due _�� — Sprinklcrs Required ' <br />/ �. � . . , . <br />Date issucd t� "'7 �7 � • • <br />. .. . , .. • ';. . • . - . <br />• . . , , . . , .. '': ''• ' , , <br />• " . . . • - � • . . ' ' ' , • <br />