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<br /> • � . I � �� � � ' � � DOILDING P£RMIT APPLICATION . � . � .��' �/�. ��.�^7� �
<br /> -- • Dpplicant To Complete This ^orm .f
<br /> ' . i ' • '
<br /> • ' If more than one buildinq is to be contructed, submit a separatc permit applica=` '.
<br /> � tion for each buildinq. .1 separate permit will be issued for each building.
<br /> ,� . 'y� Wncr �- /�,.,.."i�' .,7�4�,.1��r��: _ Bnlldinq Addrese `�.`7��C ", );c.�.z�"J/f'.�csf'�.
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<br /> '� /�' .�c*-�� ' ' 91ock �'
<br /> 7 � � � Lot /i7',�' �_� _ .
<br /> ' Mdress ,�_ it�� �i�',fr� — � �
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<br /> City ��o��il'„T;_ phone �h,� -�����Subdivision (Plat) ��u�� ` �� �-�'f'��
<br /> � �_�,.- �
<br /> ' • Lrchitect/Engince;�>7�¢f��-��_�%��!'�'�'��t��`J 7 �� � -
<br /> `"� City � Phone ,�Metes 6 Bounds (Unplacted)
<br /> � � � ,- CAntractor �� ���,2 J��i+-s{ . - � �._�ec. n+P- Rge ,
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<br /> _. . � J�ddress /� 7/C7 --�o�„i, ��/ ��i�/i-f
<br /> �
<br /> .. � ! City ;�'n.�hone � "'2=�a�1�' Buildinq Use 'h���t-�":�i '�:-�.� _e�• .
<br /> ^' � SWte�License Nuiaber -,� E n r Describe Work to Be Done ..e � .�
<br /> �i ��� - //� ,4 ,' ; ,'�;.
<br /> � '� ,' � f-F��7+ .c L� �tid "
<br /> � :. : :� Lxpiration DatE �i'. - - � �T ` � �
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<br /> �� � �� � � SRETCH PLOT PLAN BELOiP� • '. � . ; .
<br /> " ' ' i � - �� � � IIse of Building �� �� �--"����-!���•
<br /> ; .� �'� �eo-��" ' ,� `�u�-�->�� . .
<br /> , � - � �/. : � � � , � �New ❑ Addition �Repair/Remofiel
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<br /> . ; �} .-��1:!/'��'�� ' � 'paluation of Construction S " � >Y� �� �
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<br /> • /4 ..('�i�(��'� �.�N�� �` • . PLOT PLAN REQUI?tEiffiNTS .: _ .
<br /> � , : � ����� � T � indicate lot size, nane of streets, �
<br /> _ • .� C�C� .. . , : ' 'iadicate location aad width of
<br /> � t � , � • � alleys, locate nroposed and all
<br /> � � . �= / existing buildinas, sho:a distances
<br /> �., ,,(� � � �q�/. .'• � �� 1 tp property lines, show distances
<br /> . �-. �.� ,Z�� ,t�'l � /�1 �"" '"'+ 7`� � b¢taeen buildings. �
<br /> � ; /l � � / '' � ` - ' J
<br /> ���j�-/ �D /9-� ��-E"�> I.ot size X
<br /> �
<br /> • : � / . Lot area Sq. Ft.
<br /> "" � ' � - � Size of Bldg. Sq. Ft.
<br /> �� �r��j �j; , t1 � tlumber of Stories �
<br /> .� i• �. AR ei2 wo�Yk��� � . Basement
<br /> � � � )
<br /> '" � � � Signed By
<br /> ' •;. „�-�j�..�kl 1`��..� s �ur;i;i � I�� /� �7 �,� �, �� //�,;
<br /> � ',. . .' �L ,/ �( For///� 11�2-�� � 1�LS '�
<br /> . . �A r }U � Ownez Phone
<br /> � Do �r6�"�h'`iTT*'LB�Oi7 TNIS LI'4z-"'OR CZTY US" 0"L'1
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<br /> - �- Date Seceived J�6�7S Dce Zonc
<br /> ' P1an�C.7ec;: ::ur.�ber ' Fire Zone
<br /> �L� � .
<br /> Valua`ion Occuaancy Grou�
<br /> pemit Fee `*ti-� �� TYpe of Construction �
<br /> Plan Check Fee Occupant Load
<br /> . � Total Fee Due `f�/-- � SprinY.lers Required �
<br /> . .. Date Issued � � 1 � , - .• . ' . • ' . � .
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