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, � � • - .. � 1IIILDINC PERriIT APPLICATION •. . . . ��. '� d l'�� <br />" • . • �pplicant To Complete This ?orm �/' � ��' <br />i "'>�.- <br />• Ii eore than one buildinq ie to be contrueted, submit a sepazate permit applic� i 5 <br />. tion for each building. ]1 separate permit will be issued for each building. <br />� , •O . � G� �/� �.C:C! - <br />' ' Oroer _� / " � � � ! � � ' ' )_ % Duildinq Address , .GS 7 <br />a <br />. : :..1 <br />_ -: =� <br />� <br />'' I <br />rt <br />, ..' i <br />�GQreas .� �^� Lot GOT ZZ Block ' <br />, ,• <br />CYty � Bhone/� . � - ' `� Subdivision (Plat} /U% �. f�F�(��/� <br />3=chitect/Enqineer � �!/lU �7� <br />City 2hone Metes i Bounds (onplatted) <br />Contractor 'i� �� i. ti .� Sec. 1bp. Rqe i <br />1Adress 'I , .'� ' S � <br />. \ � <br />City � •+.: �_ Phone .� � �- n �.�+ j Duildinq Use ,: �.� <br />ttate License Number :91 � l��� �i -�L�.2 YDescribe Work ta Be Done ��� �� <br />�piration OatE <br />�l�� .�L.�� . <br />� SICETCH PLOT PLAN HELOW � � V" ��✓�u'� �� � � 5 i/J� S <br />�r � ' � � '' � Of! of Puilding � .- _ __ � <br />� ��� �! /�� ` �� �� � ��+, ❑New ❑ Addition C�epair/RemoGel <br />���, .�"' A� c <br />� � �' � �_ .r"_; �/. ` p_„ ' 'Valnation of Construction $ �i %� �� <br />i : I�TIr�i4S IZ��WIOE'.'�C 'I <br />Ga p�w9p 11 ��i►luK•. ', ' <br />pLt� '1 � ' �, <br />� y 7.. 1 . <br />- ��,p�� � <br />� ` . a _ + G�{f�s. .. <br />pZOT pLAN REQUZREM£NTS <br />Indicate lot size, nane of s:zeets, <br />��,j �iadicate location anH width of <br />�/ alleys, locate pr000sed and all <br />. lxisting buildinqs, shotv distances <br />.. t0 pzoperty l.ines, show distances <br />b¢tveen buildings. <br />v�� � � 11 � V p. G: ' '. I ' Lot size x <br />� � .... ��. �'i . ��3Z � l� , Lot area Sq. Ft. <br />��.,. � !' C� ��,�O.G. �" Size of Bldg. Sq. Ft. <br />J '�/ � Number of �tories <br />'.. . �1��-+ _ a . � .�. k'aiQ easement <br />;�,��' Q_� lC .7 "Q "` `� i C�� ' � J / � <br />� �"^ Si ned 8 ' ' <br />p F, �. .� 9 Y /l i �•_ �� V�%'-. c j �_� 4' <br />�� �/ .(,�-GL.1.� t�� .�.' �tt:LT-cc,�" � ( ' <br />�'..- , - � 1- �.z � �C�'�`;7't2"l For Owner Phone . � -�-'�.�. <br />�_ ��-- . ' <br />I� <br />�.. <br />,�� zc , a< • J � <br />J�� �� t �z � � ' - <br />/� DO t70: Si:iITB B�LO[7 iHIS LI:IE-rOA CTTY USE OE7L'L <br />J <br />Daie �eceived <br />Plan Check :tur.,ber � 7� —��f � <br />Valuation 7i ��� <br />temit Fee /� ¢• �� <br />Plan Check Fee � <br />' SbWl Fee Due ZY+ 07� � <br />i <br />. Dale Issued ' � z(' <br />Ace 2one <br />Fire Zone <br />Occunanc� Grou� _ <br />Type of Constzuctian <br />Occupant Load <br />Sprinklers Required <br />. . `. <br />