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. , • DUILDING PERMIT APPLICATION • �� - �.� <br /> • Ap�ilicant• To Comp].eL•e Thi: lorm ' �� >�' > <br /> �//�,� <br /> Zf mo:e L•han one building i.^,� to be constructcd, submit a separ.nte per.m�.t <br /> appiication Por cacl� building. A separal•e pc�-mit �•�i.11 be is,uccl for. cach • <br /> builr:ing. ,� <br /> ,/� � � <br /> Owncr � I � ,�'� �°��.�. IIuilding Address _'�5c'�l i ��'v;� <br /> Address ��tD�; l,+) L�.�.,,,..1 J Lot• I31ocl: <br /> r <br /> City �� Plionc fl.ti � ll • a Subdiyisio» (P1<zt) • <br /> Archi�ect/Cngincer <br /> City _ Phone Metes & Bow�us (Unplaticd) <br /> Cont_�ctor Sec. Tc.�p. _ Rqe, __� <br /> Addr�:s <br /> City Phone • <br /> State License humber � <br /> Er.pirztion Date � <br /> ' Building Usc �T <br /> • Describe i•:or}: to IIe llone ,µ; <br /> C01�:": PLOT PLA27 0:7 R��15E SID^s — " �" �`�' <br /> . � <br /> Number of Stories <br /> . . • � Sasement <br /> � � ' " 11ew Afidition Repai.r./Rer,iodel' <br /> . . , • '. . Valuation of Construction $ l ,00:, <br /> _ • Signed By � I�J-eL . J n1�,�-- <br /> � . For � � <br /> Owner � Phone <br /> _ • Do t�ot T•;rite IIe].ow This Linc -I'or City U,e Only <br /> Dai-c �eccived �/ � /� h ' ' ' ' ' ' . ' Use Sonc � � <br /> 1Tlan C;�ec): NLmber - ' • Firc: Zone I ` <br /> Valuation -- ' Occupancy •Gro�p � - Z <br /> Perr�it Fee _ �� ;r-t� Typc of Consi:ruction ___ ' <br /> Plan Clieck I'ce ' — Occupa�it Load <br /> Total 1'ec lluc i � , ,t—c) __ Sprin):lers Required <br /> Datc Issued � / t / � � � . <br />