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<br /> -• � � � � DDILDING PERMIT APPLZCATION � � �''�2
<br /> ' . . . . . . Applicant To Complete This :orm - - '�',j
<br /> . ' �C �/'� - /� � •. •
<br /> , Zt more than one buildinq is to be contructed, submit a separate permit applica C%3 Z
<br /> : tion for each buildinq. A separate permit will be issued for each building. �
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<br /> . � Ovner 1;EUHOLOGIr_P.L A`;s(v�7I,'i�;_`3 1'�',� ' cific ��`� `��-�
<br /> , Buildinq Address �
<br /> , . 1lddress t�15 n,,c i f i�- Lot 17-21 Block 71 R -
<br /> City 1;��cr, ct Phone Subdivision (P1atJ ;,�,r <,f r.,.,,,...r
<br /> , ' • 1lrchitect/Engineer t�on�. �
<br /> : � . .
<br /> _ -� City Phone Ftetes i Bounds (Unplatted)
<br /> 4. '� COf1tIdCLOt _.Avpr Clc�n�-'L•Vrtinr lnr $0C. �7. RQe � .. �
<br /> _ , llddress b'�2'S IS�verly T;Ivd„
<br /> ' City I;cc� ci C. '�'�� Phone �!5''—r;4?7 Building Use � �
<br /> `� - ' . � r . ' �i
<br /> � �,:j � State License N�..-�aber , ` I�c.-r�..,-.:714L2 Desaribe Work to IIe Done 1-.��7nc.7Ce ��ff���:,.
<br /> ; � I Expiration Dat� 1?77 ' i�o��c 3 uu•r ���r;-�. ,.,,ll
<br /> ; .�'unr r,.; � , .
<br /> ��, ♦ � SKETCH PLOT PLAN BELOW' • �
<br /> . , • i , , � -
<br /> : ,� Oce of Building pr��[��r'a of)'ic� '
<br /> � � . . . . • QNew
<br /> � • ❑ 1.ddition Q Repair/Remo5el
<br /> •
<br /> - • . � Valuation of Construction $ ��pp.��
<br /> �' � . � . . . ' . � . . PLUT PLAN RPQUZRElfENTS , I
<br /> i ' � Indicate lot size, name of streets, ,
<br /> . , � . �- , . ' . � �indicate location ar.d width of
<br /> ;•'� • • � ' . alleys, locate oroposed ar.d all
<br /> �: -� - . . ._ _. y , .�. � - existing buildiags, show distances
<br /> f . � � � •. � � � � to property lines, show distances
<br /> � , , � ' between buildings.
<br /> • • 7.ot aize X �I
<br /> .. �
<br /> : 7.ot area g
<br /> q. Ft. /
<br /> <; r' � ' Size of IIldg. Sq. Ft. �
<br /> � s-
<br /> • � Number of Stories I
<br /> :.. • Basement
<br /> � -. ^ Signed By i ,j_ ;;� _1/� ,�a
<br /> i +�
<br /> � For _ /��� (�:.�p�le�
<br /> . � , Owner Phone , � _ , �,
<br /> . DO :IOT Si:iIT� BELO[7 THIS LI:JE-POR CITY USE OiIL'!
<br /> Date �eceived Ute Zone
<br /> Plan C:ieck `7u.�bet ' Fire Zone -
<br /> Valua:ion Occunancy Grou�
<br /> Pemit Fee R�,e of Construction
<br /> Plan Cheek fee Occupant Load
<br /> . nl,,l. of EvereCl , :,, .,lat lilocl; 71B R1} -
<br /> � UAF Deg SE Cor Lut 17 Blk 718 2h N Alp 'il��:,. ��1,�1 1�'f; 1 , � ; 7'-?l �
<br /> .:ve for 90 Ft Th wly prt �7 11.; �pt 30 for 81.9 �:C �,Swiylat p
<br /> • ��51� ,Ang Ta�o on a LN Th ia 95.'� pt W af �, plt The g LN; of I,CT; • •
<br /> 1J-1,9-D4 G 20 � 15 79 Ft N-of 5 tN oF SD Lot 17 Lh s F1t L LNS
<br /> ;c Lnta for �9 fit co S LN SD Lor 17 th E ?2.9 i'r -n-,. '
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