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. . . - <br />� BOILDING PERMIT APPLICATION l -�-� ���,_j� ' � <br />• , . Jlpplicant To Complete This Sorm j`/ �� �J j� <br />. . � .1. C�l�� <br />'Li more than one building is to be contructed, submit a separate permit ap�ic� <br />LiOn for each buildinq. T. separate permit will be issued for each building. <br />Ovner ��c.(� _Y�,4„ � � LA_. Buildinq Address a (, /S �-�-. ` �" <br />/ . <br />Sddress a �.P � 5 %/ ,, � „ . Lot 7 � �' Block b O � - � a ' <br />City •�� 2hone a 6a-y�} 5— Subdivision (Plat) � ti. ., ' • <br />Urchitect/Enqineer � a _ , _ ��l�79 ��� <br />City - Phone Metes G Bounds (UnFlatted) <br />conara�cor ( f�..�a-„�a.o Co-.�.�G �" <br />1lddress _,�317 � �-ti<9. <br />City L�-t-.A'tr-�, Phone �SJ--S.7 / Z <br />State License Number d�3-o 1-r1 �� � S <br />Lxpiration Dat� <br />SI�TCH PLOT PLelN BELOIP' <br />1 • <br />. . ... .. .� : <br />Sec. 1h�p. Rqe <br />� <br />Building Use ,_jL¢� • ' _•;:>'.., <br />Describe Work to Be Done �c�t..--.�.� <br />� . <br />Dse of IIuildinq � <br />❑Nev ❑ Rddition �ir/aemo�el <br />'Valuation of Construction 5 O� ]0 � � <br />PSAT PLAN REQU2RE.�LAITS . . <br />Iadicate lot size, name of streets, <br />�indicate location and wicth o: <br />� � alleys, locate pr000sed and all <br />existing buildi:gs, sho:o 3istances <br />. to property lines, show distances <br />between buildings. <br />� � Lot size x <br />� . Lot area Sq. Ft. <br />� S3zc of Bldg. Sa. Ft. <br />Numbcr of Stories <br />Basement <br />Signed Sy i <br />For <br />. Own Phone 2 SZ-� Z/ L <br />. � <br />� DO :70': 6::2?TL' BELOt! TNIS LI:IE-cCit CITY ❑SH OtIL'l <br />Datc �eceived ���� �S �' U:e� Zone <br />- i . <br />Plan C:uc� :tur..ber <br />%i%(iO • mCl <br />Vaiva:ion <br />�1� �o G <br />Pemit Fee <br />Plan Check Fce <br />, • 1bta1 Fee Due ��� � � <br />• � <br />�atc Issued •�p�Z¢�7 ) <br />Fire Zonc <br />Occunancy Grou� _ <br />Type of Construchion <br />Occupant Load <br />Sprinklers Required <br />