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. .. . � - <br /> • � � � � DDILDING PEP.MIT APPLSCATION - '� � C �j;j <br /> "' - � Applicant To Complete This Form ' � �- ' <br /> . . , � � �J, ./, .> <br /> • I! more than one buildinq is to be contructed, submit a separate permit applica- <br /> � . , tion for each buildin�. �1 separate permit will bu issued for each building. <br /> ; ' Ovner ` �L`Z�i'7 ?/�cZ� � `� BuilAing Address J:�;a i //_c.t,tjl�, ,: <br /> , 14ddress j ,� ;� ? ��-t��,t� Lot � �n �lock i i�.�� <br /> City � � ^�• 7 , / <br /> Gy!-t�iL�-yc Phoneo.J.�'������ SubdiOision (Plat) . .2_ —A� <br /> ' - ]Irchitect/Enqineer � ' ���- ����� ������ �o �t�'-<'-u'-� <br /> '"` City Phone Hetes i Bounds (Unplatted) - � <br /> - �j <br /> . :, Contractor �.Y ���.c.f {� �?.�J��c,e2:�� . Sec. '[wp. Rge � <br /> :. . , 14ddress ,�j/ !' � ;-�:,></ • • . <br /> , 'i City ��.�-cC_e Phone;T�:.��-`-��"���L Building Use � "•: .��. <br /> - -�i � State,License Nu�aber N,,;���c^� - YP ��i Descrihe Work to Be Done � ���'� � <br /> � : �I Espiration Dat� � � �� �C�4 i ( �..��--< f� - <br /> �� � - � SKETCIi PLOT PLAN BELOi4' ' <br /> � • � ' � Ose of Building � <br /> ' . � <br /> : j . / - . � . . . . . <br /> �� � � � ' �/�az��- �?�-.'� _ _ , , � []New ❑ Addition H'kepair/Remo�el <br /> " . , ;�.[uZ€-/� , : � ' ' ��� .�� <br /> � • � Valuation of Construction 5 <br /> �L<�(.K. <br /> _.... e j C •�7LS�i.e ,a-�--•. .�`�• � .� : PIAT PLF�J REQUI4&"tENTS �. . . � <br /> (�C � <br /> ' � - � �,�,�„tL�-�i+�'`-r�" `'� '� • ZDdicate lot size, name of streets, <br /> � � ; � • ��w� ' ' � �indicatc locat:on and width o: <br /> . , I V ��,, �j�jl..�" ���'.�"�"��.�•�� � �� � allcys, locate pr000sec a,^.d all - <br /> . t•:� . I exir.ting buildings, show distances <br /> -�' -• •- ti to property lines, show distances <br /> ' � � . �� � • betwecn buildings. <br /> ! � , _ <br /> � � � . ' � � Lot size x <br /> � .,. � � - . . I,ot area Sq. Ft. <br /> , : : • � Size of IIldq. Sa. Ft. <br /> � ; - . Nunbcr of Stories <br /> , � �,; , :� ' , Basement � <br /> :.. . <br /> � <br /> 0 �� / <br /> '- Signed By� � �/+ A' i 1��i'.0 c-1- <br /> ;� , � <br /> // z- <br /> . � FOI .�� i r i L�6 al i L��i�1 —�'� [ <br /> � � ner Phone <br /> � DO ;70': k3IT: BELOi9 THIS LI:�£-cOR CITY US'a OifL'I <br /> Da[c Seceived U:.e� Zonr .. .. <br /> ' Pl�n C:�ec:: :Jur..Ser � � Fire 2onc <br /> Valuation Occuoancy Group <br /> Pesnit Fee � Type of Constructiun <br /> Plan Check Fee Occupant Load <br /> ' Total Fee Due . Sprinklcrs Ftequired _ <br /> ' . . <br /> Date Issucd � • � . . . . � • - . <br />