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• � BDZLDING PERHIT APPLICATION - 7��,.'.��j
<br /> :' Applicant To C�mplete This =orm � '% � " <'�' -
<br /> . � • . �//.�.�/->.;
<br /> � Tf moxe than one b�ildinq is to be contructed, submit a separate pexmit appli�'a-
<br /> . . tion fir each buildin�. .1 separate permit will be issued for each building.
<br /> ' � (h.ner i-i�'t.J d Li; a.:�• Building Addtess � " _ -�.-tr �
<br /> ' , 14ddress �' �� � -c i�< Lot � 0 Block !�(_;� _ '
<br /> City i. z<': . - " Phone . �"1 SubdiOision (Plat) !�;�::, ' '•'��>� > •
<br /> �. � �.Z ��i� .
<br /> i .7 �/ �) .l �
<br /> ' - Architect/Engineer -� -
<br /> '-'� City Phone Hetes S 8ounds (Unplatted) _ �
<br /> iCont�.actor �rc r�-----t=rs•-f�- �-.•Z�--�/ Sec. !L TwP•_..;�. R9e _ '�•'',
<br /> _ ]lddress " � �.� �, , '
<br /> - - -- � �
<br /> +' �;ity �.�r.'�==�-Z'hone _ — Building Use /�"s�,l.z�' ;
<br /> •� :�-
<br /> � ���i State License N�er _, Describe Work to Be Dane .r ,,.�,.�: .: i� <��. �� �
<br /> � � � �� Scpirar.ion Lata ' _ . r - � i:.-.,;,.-;� '
<br /> . , �
<br /> .1 : � � � SRE"Cf{ PLOT PTu1V T3Ei0W' • � Y'.t'r.�....� - .
<br /> , . : I / s----.-- ------�__, Ase of ➢uildingN ;r, ; '
<br /> 1 . 1
<br /> � ; /.�� • .' ' , � `�\[]New ❑ Addition [�Repair/Remo:3e1
<br /> � ' ;�-� _ � .� . ' • ' \. aluation of Construction 5�
<br /> •-.... i � - _� ' I"J ' I. ..� PLOT PI.A2I RF:QUI?iE�L.1T5 .
<br /> ' • . I �I-. ; ��' I � r ! I`I'; �' - �� �1tky• • � , I , Tndicate lot size, nane of s:reets,
<br /> I—'-__I ��- _ ( �indi.cate 1�caAion and wicth o:
<br /> l . �y"• y : :' i ` �r ._t _� t'-:. ', . . allcys, locat_ aropo�ec aad all
<br /> � . ,.� ' �—__ . existing buildi:gs, sho:a distances
<br /> ��1 <---�--�-1 .•R ' � to proper.y �ines, shcw distances
<br /> . ..;,. �,�� ��d '�7% � ,� � • �ro�rLSt� lA':CO�.'�' ' '- .
<br /> � f , between buildin3s.
<br /> � � � � � r n:� '.A�a.��'��,
<br /> ',/ / , k � i / >a na A
<br /> � �1�2.l./.J Lot size /�5_. x � i 7
<br /> � �� •_�If r ..���1 W� ., .. . . - �' N.�� ��. . Lot area ,(,[�f-�J Sq. Ft.
<br /> . _ �..pii Size of Bldq. , 4^r�.� Sa. Ft.
<br /> -�j � , � . Numbcr of Stories /
<br /> . � -.� .,i� �:��� , Dasemcnt _
<br /> ' � �� �
<br /> :: _
<br /> "� Signed IIy '
<br /> �� ... ,
<br /> 7� /
<br /> . ,
<br /> �
<br /> , ' For � '•�[ �. �/�d �.
<br /> -,.� � :./Owner��� ; Phone �_7.�
<br /> � DO ;�OT S•:3ITL SELOF7 THI� ;.I:7E-POR CITY USE O:Ii.7
<br /> Date �eceived tT�e� Zonr
<br /> ' Plan C:icc:: :la:.Ser � � Fire Zonc �5'�
<br /> Valuation Occunancy Gzou� I
<br /> Pemit I'ee � Type c+f Con:,truction ���' - 1��
<br /> Flan Check Fee Occupant Load
<br /> . , '� TOCal Fee Due Sprinklers Required �
<br /> Datc Issucd • • , � . . , . • � - �
<br /> � � . • � � �- '�.� . . , . .
<br /> - - � ' �/Z� % -� 1 I[� . (._ .
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