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_.�, • J ' "� � � ' lOILDING PERMIT APPLICATION ... . - • � j' <br />' ., ;' ' , : >pplicant To Complete This :orm /�� ��! <br />, • 2f eore than one buildinq is to be contructed, submit a se arate y/��� <br />tlon !or each buildin A se arate p Permit applica- <br />, 4• p permit wil.l be issued for each 6uildirq. <br />;i� Orner � -�*:cN '.� -�a%�. ,;� Duildinq Address '�sic�" �,, <br />� / _' . _._ •. n_[ <br />�Edreas .2�0,'� - � . <br />,/��,'c.,,.c �.._ LOt.^_.-• r? I H10Ck �''� l . <br />(-. / " - ` . '- ... <br />C1ty G.' �'� _ Phone i�S s ��-� g1pdivision (Plat) � - % • � ,�%�%j , r / <br />, <br />itchitect/Enqineer � � <br />:..I ' <br />- - �} CitY Phone <br />, Contractor �'.e r'� <br />_ " 3ddrees <br />� �tY Phone <br /><.; ,,. <br />�j 6ttte.License Number <br />� : �i �piration DatB <br />`\: �" . . � SRETCH PLOT YLAN BELOW� � <br />�� . . <br />� . , __ . _. _ ___ <br />. . . ;" i .. ... . . .. <br />� �. . <br />� i . . . <br />�. � � . - <br />y . .. � <br />• • • <br />' i . . • . � � <br />• + - • -. <br />;'1.2 . : _ ' .'I, <br />. '1 J I . . �+ Y�� I` <br />' ;O� I • 'i <br />.... � _ I ' <br />. . ,� . <br />.: a ' <br />� •. 5r.. -� � _ . � . <br />t _ � <br />. '.. -�; <br />r.. _ l'. �,,,�� 42, � .� ��...�c�. _-a� <br />�. ��� . . )C. <br />�.' � x-.� ,y� x x� JC 1�� <br />. `1 ��"1 I IJ i' 1� , <br />Date �aceived �(-I 1 d=1� 1'� <br />Plan CSeck Yur.,ber � <br />valaatian Z �� �� <br />Pemit Fee 5 , �� <br />Plan C6eck Fee <br />. ' ibtal Fee Due S. � U <br />'. ,/ , S- <br />Datc Issued __�,L <br />![etes t Bounds (Unplatted) <br />Sec. 1Vp• Rqe <br />Huildinq Use � <br />— , ' �.' <br />Describe Work to Be Done ����. <br />' �ot� ��t �_T T—tNc� � <br />4z.'� ' <br />Ose of Building ' <br />�Nev ❑ ]lddition [� Repair/Remouel <br />,Valuation of Construction $ <br />. . PI.OT PLAN REQUIREh1ENT5 <br />Iadicate lot size, nane of streets, <br />'indicate location and width of <br />� alleys, locate pr000sed and all � <br />lxisting buildings, shoia distances <br />to property lines, show distances <br />betaeen buildinqs. <br />Lot aize x_ <br />Lot area Sq. Ft. <br />Size of S1 q. Sq. Ft. <br />Number of Stories <br />Aasement <br />Siqned By `�%14a.������E.�e->> d�+ . <br />�� <br />� Por �-f-z>�f<�. �� ��.-,z� <br />OW�er Phone zS�-= - �'cC• g <br />CiTY <br />Ace Zone <br />Fire 2one <br />Occuoancy Grou� <br />lypc of Construction <br />Occupant Load <br />Sprinklers Required <br />