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i DOILDING PERMIT APPLICATZON �/ '�'j� <br /> -• � . . Applicant To Complete This ^orm /// `7' <br /> I! more than one building is to be contructed, submit a separate permit applica�//; <br /> � . tion fo�ach building. A separate permit will bc issued for each building. <br /> � ��'��j' ��2����L .� <br /> � ' py�eL �-� � � </ L �.� t; l� I �I _ duildinq Address � � <br /> ' � <� , 1�. � �/ s . <br /> � , llddress L/���� � 1 � '' �. C Lot l / Block . <br /> City �'-��=•\ < 1 / Phone�y���� �S� Subdivision (Plat) ' <br /> � � Azchitect/Engineer G�� � � �' � <br /> � '� City Phone Metes 6 Bounds (Unplatted) _ <br /> � Sec. 'h�+P. _—R9e - <br /> Contractor � <br /> Iddress . - - � <br /> City Phone Buildinq Use ��-'?. ,-. <br /> : <br /> �' SWte License Number Descrihe Wo:k to Be Done <br /> � :I � <br /> , . i . <br /> � . . . `___ . c._� l_il.,.'... I�:. :'TIe7 . <br /> ; • Lspiration Dat� <br /> �� � SRETCH PLOT PLAN HELOW� ' � , <br /> • ', ' �i � �i � IIae of Building — <br /> � � � I _ � '_�l,� � ONew ❑ Addition ❑ Repair/Remo::el <br /> � � �C.. <br /> ,� � . , ; �,� . ' ' ' paluation of Construction S ��� � <br /> ,�. <br /> . 1 I • � PLOT PLAN REQUIR�fENTS . . ' <br /> � , � • � I Tndicate lot size, nar,.e of streets, <br /> - � � �-�' - �indicate .ocation and width of <br /> � ` . ��� � alleys, locate pr000sed and all - � <br /> ' � � �� I � � '_ . txisting bu:ldings, sho�u distances <br /> � �_� .. .. y : _ __- � ... . to property lines, show distances <br /> . . I �� � •— -� betwecn buildingc. <br /> � � ��'��1 <br /> �`� _, <br /> Lot size X <br /> • � � - �- ` Lot area Sq. Ft. <br /> - •- . Size of Bldg. Sa. Ft. <br /> • .:. ' Numb�r o: Stories <br /> � � Basement <br /> � <br /> :.. ' i. � ( ����----� �-� � ��- <br /> . � . <br /> ._- Signed 9y'�-`- <br /> For <br /> � • ✓` Owner Phone,� ` / . <br /> ---—�^ . <br /> DO NOT St:2ITL BEL0�4 THIS LZ:7E-FOR CITY US'c, Oi1LY <br /> � � Uce Zone � <br /> Date Seceived . <br /> � Plan C:teck :Iur..Ser - Fire Zone <br /> Valuation l�� �� Occuoancy Grou� <br /> peroit Fee �J - � Type of Construction <br /> Plan Check Fee Occupant Load — <br /> S�. ��'2 Sprinklers Required <br /> Total Fee Due � - <br /> Date Issued •��_— . • • ' ' <br />