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. " __ ' "_ __ "".. .. . _ "" ' '_._'.. . .0 <br /> � BUILDING P�RMZT APPLICATION / �/-� � V <br /> Applicant To Complete This ^orm � ����j7 <br /> If more than one huilding is to 6e conY.ructed, sutmit a separ�te permit applica- � <br /> tion :or each buildir.g. A separate permit will be issued for each buildinq. <br /> Owner y (il � Huilding Address %;i_1, / 5 �-r• <br /> Address Jl,xL/� Lot ;/� Block L/ <br /> City �,%i%k��rT� Phone Subdivision (Plat) �-1.. ��� �,ly� //�,r � <br /> Architect/Engineet ��»� C'cJ'Y-(G/% —�J��9 G� <br /> City Phone Metes 6 Bounds (Unplatced) <br /> /� , <br /> Contractor 1��,;nrn l,�in ��n-sY! Sec. 7Wp. Rge <br /> Addzess /i�7,� q ;,,/��j�y,�r�c 2� <br /> -� 7 , <br /> City , / Phone ��y-dHf'f Building Use (/:p�:ft�! c:� � � <br /> State License Aumber ?�2,�-Ui- �75"91 Describe Work to Se Done � <br /> � /' / <br /> Expiration Date 1��5-�j,� H�n.ae ���f�./ � _ <br /> SRETCH PLOT PLAN BELOW � <br /> • -, . <br /> Dse of Building J_ ;- �. . <br /> � ❑New ❑ Addition Repair/Remodel <br /> � - Valuation of Construction $ (�.U� D <br /> � � • PIAT PLAN REQUIR&�tENTS <br /> Indicate lot size, name of streets, <br /> . indicate location and width of <br /> alleys, locate proposed and all <br /> existing buildings, .show distances <br /> � �. . to propezty lines, show distances <br /> � . between buildings. <br /> Lot size x <br /> � Lot area Sq. Ft. � <br /> . � Size of Bldg. Sq. Ft. � <br /> • Number of Sto�ies ! <br /> - �� . � Base�:e,^.t � <br /> . Signed By _� -�,.�> ���-s'-�� /�,y�jr� � <br /> � 4 <br /> For �Owner Phone 31t�-o�itr' <br /> � <br /> DO NOT {4:2ITG EEL0�4 THIS LIi4F.-h'OR CITY USE O:ILY ' <br /> I � <br /> pab, ^^cei';efl ._1-��., U•_e �onc 1 <br /> Plan C`ecb; `lu:-,5^r Fire Zone � � <br /> / �+ !� r� <br /> Valuation (s� (G' � Occuoancy Group <br /> � c <br /> Pemit Fee �Q Type of Construction <br /> Plan Check Fee Occupant Load _ <br /> cT <br /> Total :'ee Cue G�� SprinY.lers Aequired � <br /> i <br /> o�co i,-�,a i'�` 'Z�-1� � <br /> ���_� ' ,�=�� 1 (_ (� � �` ! <br /> I <br /> r � <br />