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_ • • } • — . � . , . . . lIIILDING PERMIT APPLICA�PION , '. ' ' - � '' . �.. <br />� • ipplicant To Complete This :orm � . •�.�� ��j� � <br />. � �. � . j� } . <br />� � %'1 <br />. 2t sore than cme buildinq ie to be contructed, submit a separate permit applice-y/%S� <br />•. . t10n for each buildinq. 11 separate perTit will be issued for each building. <br />•. ' �� �� � i= � .�AiPT.4 TT lnildinq Address �_o2a� / [J'�p���'n �� ; <br />� <br />. : <br />a iddtess a�a �� ,'n f.a � LOt Slock • <br />.,' • . �t7' - F i? -' T T PAone ,�G a - 35 � � Subdivision (Plat ) . <br />_ � � 1rchltect/Enqine:er � <br />� J'.., .��j �i� p�e Ketes i Bounds (Unplatted) ' <br />_ ti . <br />-. • : <br />:.' Ooatractoz _�j'_� � � Sec. itap. Rge • <br />.� . <br />-%' • �' lddress . '. , ' � <br />- :� «h' Phone Hnildinq Use , • ,. ��:s <br />_,,` ir,+ .. <br />_ ; ..'4f �r:c� . . .: r.Y,. <br />_'' :��f� itate,License Nw�tier Desaribe Work to Be Done `�.��� <br />: � • �.I- L=pization Dat� _ . . �� e rf�Ci" '(a � �e n � h �r?�p.a 2 io920 � <br />�1: ." - � � - • . . <br />• BI�TCF[ PLOT PLAN BE7AW' • � - � <br />�. '�.'r� ` . . ..: . . . ... , • � • - . . <br />II�a of Buildinq <br />� + ��New ❑ Addition �$,Repair/Remofiel <br />.�. - . ' ! : .- .:... i. <br />� . � •' ' Valaation of Construction ; 30 D i ��� .' . <br />�' . . <br />-`�. '� . . ���C�� i ��� _ � .�� .. , . lIAT PLAN REQUIREtfENT5 � . <br />�' ; � ' • �'-'�. ' • • ' Iadicate lot size, name of streets, .; <br />� �� ' �' •indicate location and width of <br />' ''j � - � alleys, locate pronosed and all <br />- - .��� � � lxisking buildinqs, shota distances � <br />I.� _ " ' �"� � ; •��'' . • to property lines, show distances <br />',+.; ' • �1�u5eJ • betaeen buildings. - ' . . <br />� a'. _',. . • ; • I1ot size x <br />..i- � � . . � . • � . <br />. - . � - � � • 2.ot area Sq. Ft. <br />. � �� f• � .. � ' . , - Size of Dldq. S Ft. <br />� . , Number of Stories q <br />"= '� • - Basement <br />. J. . . . ' � , . . <br />�� �= . Signed By <br />' ,• � :' . . . . v��� • �- %� �// <br />� ; ' , " � . � . . � . . . . '�. FOt J_L1d.G . 1 C �i Kli� n 7�i /Y� - . <br />. . _ Dwne Phone aSa-3SR9 � <br />-. ' DO NO': Sti:2ITB 9EL0[4 ^_HIS LI:IE-FOR CZTY IISE 027L'! <br />-� --, Date �eceived � %� ^ ' Dce Zone <br />' Plan. CSec;; :Iur,ber `-1� � _ <br />, � Fire Zonc <br />Valnation v�OD- g-'— Occuoancy �rou� <br />Peroit Fee 'J. � 2ype of Construction <br />. ,' 'Ylan Check Fee � � ��Oecupant Load <br />. : Sbtal Fee Due 5' � Sprinklcrs Required <br />Date Issued ' �Z '7 � • � <br />.. . . " . • � . . . <br />. � • • ' . . . , ' <br />' : � , . � . ' . • ,� '. <br />• �: <br />' � � <br />