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. , - <br />; � ' BOILDING PERMIT APPL2CATICN �7 ' •' <br />: ' . Applicant To Complete This ^��rm � / ��� yl � . <br />. , ��i��;�1 <br />• If more than one buildinq is to be contructed, submit a separate permit applica- <br />.. tlon fos each 4uilding. .1 separate permit vill be issued for each building. ' <br />�� 0`mer �%%C�L�-F,� L �-�c-wU Huildinq Address ���, (� % ji�s ,��.._: <br />, ]Iddress O� � %���i 4„�,,«�. Lot ,:� � j Block �-C� ' <br />�. J <br />City T�t.�.� i�f"Phone Subdivision (Plat) • <br />, . '7. <br />. • llichitect/Enqineer �iJ ��— L � ��_C%.T�j� � • <br />`"� City Phoae Netes i Bounds (Unplatted) �� <br />i /1— <br />� .,� Contractor ��. L/-l_��'���f ' Sec. 1M�p. Age � <br />� �' Eddress . J � 1 i j�� %3 .,.P . • . <br />' City �L.�) - Phone ��� S ��7 Buildinq Use � ;:-' � <br />• �. ..:. <br />� j- StatP License Nc.�er P%� 3-�'� -�� �� Describe Work to Se Done `. �'� �. <br />� �1 E:piration Dat� ' � ' <br />w <br />SICETCIt PLOT PLAN IIELOW' <br />�� : �� <br />. .��:, <br />..-•... .,y : <br />• <br />DO 270': St.^, <br />DatC SmcCived <br />Flan Chec� :7ur.,Scr <br />Valuation <br />Pemit Fee <br />Plan Check Fee _ <br />1bta1 Fee Due <br />�atc Issued <br />�J � <br />Qee of Building <br />. �New ❑ Addition ❑ Repair/Remo_el <br />� 'Valuation of Construction S <br />PIAT PLAN REQUIRi?lENTS - . <br />Indicate lot size, nane of streets, <br />�indicate loca:ion anc width of <br />- alleys, locate or000sed aad all <br />existing buildi:gs, show distances <br />to property lines, show �istances <br />betW¢en Luilcings. <br />Lot size x <br />Lot area Sq. i�t. <br />Size of IIldq. Sq. Ft. <br />Number of Stories <br />Basement <br />Signed BI _ <br />For <br />Ownez Phone <br />TtiIj LI:IE-POR CITY USB Oi7L'L <br />U�e Zone <br />Fire Zonc <br />Occuoancy Group _ <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />