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•:,ppL'r�n� 'lo �c�pletc rnis :ocm <br />If norc th�n onc bu:'dir�q is to bc contructed, submit a separatc permit ,ipplica- <br />tion for each building. A separate permit will be issued tor each buildinq. <br />,�.,,; ,� ��v�y � ��/ � <br />Oirncr Building Address � %��- ,(1� � <br />Address �` % �'� ` �hc! l�L�-G.Sn Lot�_ Block �� ��%� <br />City �1��'y�� phor,c ���J :.I ��� Subdivision (Plat) �p�) p,� %eJLl1,7� <br />Architect/Enginee: �}.��i� y ��t . <br />city Phonc SAM � rictes a nounds (unpiattea) <br />Contractor _i 1 B✓ EY Sec. 'I1�p. Rge _ <br />Address <br />City Phonc � q �f — � / �-s/Iq� <br />�Ay%C'i Bui.,din Use <br />Statc Licen�e Nu:iber Descri6e Wor'r. to De Cone <br />Ex-iraticn Date �Y�f£ ! - "�2C/-s <br />3F.ETCIt PLOT PLi,:7 F3Gi^'4 <br />I <br />Use of Suild:ng ..J�p�f.�jLY _�.�7.zo�-S�'��'�Y` <br />i <br />�New ❑ Additicn ❑ Repair/F.croCe' <br />�j� Go <br />Valuation of Construction S�Jr-�_. <br />CIAT PLN7 REQUIR��IE::TS <br />lndicatc lot sizc, namc of scr_�-c.:r., <br />indicatc lo�ation nnd wic�h c: <br />allcys, locate ❑roposed �nd :.!! <br />existing buildinas, c�ow d:_�..�.... <br />to property lines, show dis_r�.:.�r�->. <br />betwcen bui'.dincs. <br />Lot size ��x�_ _ <br />i,ot area 7DC ��. �'-• <br />Size of Bldg. , ' _ �q• r�• <br />rumber of Stor:_s / <br />o�ac-_.._ � 'N, � <br />Si^yn�,3 5� `/LL��� �������� <br />E -�ti'�-r-���L- <br />i�r <br />� C.:ncr enone -- Z7�� <br />�-,.,� •.n_. -: r- - : i:; i' - ';.'r' OSE O':LY <br />. :tr :- -.._-. Uce �onc� - <br />'? _. . :cc; •:cr_ �_ <br />ValuaYioa 4 � J�i. � J <br />Pemit Fec 'zk , e C <br />Flan Checi: Fec 14-�.?�= <br />Total Fee Dce `t-�� :� O <br />Fire �onc <br />Occup�ncy Group _ <br />7ypc o: Cor.str�ction <br />Occup.�:�t Load __ <br />Sprinklers Required <br />( , i r (.. <br />.. _ -^,�.' • ._ _ <br />_� <br />rr� ; <br />��� r �. .. . . . . <br />