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<br /> ,. . DO'L:DING PERHIT APPLICAT201; . , , ; .
<br /> — , „ } , • , : llpplicant To Complete This :ain � •
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<br /> . ' I! more than one building is to he contructed, submit a separate permit applica-
<br /> tlan foz each buildin . �1 separate permit will be issued foz each building.
<br /> , •. � ' Wner //r, f .� '` �r(�.v�G%�ildinq Tddzess � � ����`rXtC�.LY�'�`��
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<br /> . �.�� �'� C���°L "/ slock J'l
<br /> a . ` . � �ddrese ' 7 � .
<br /> � • � � �ty . .e � � Fhone - c'� %� Subdi�ision (Plat) �2 2�-�- ' •
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<br /> ` )sohitect/Enqineer � __ -�— - �
<br /> . r ' = � �tY �_ • Phone Metes L IIounds (Unplatted) � _
<br /> _ . ti', : •=i • .
<br /> :., . . , Rgc
<br /> � Coatractor Sec. T+P• . .
<br /> :�'. .
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<br /> � : `;� -.'' Mdress .
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<br /> , 'f City Phone Buildinq Use y-L =�_:,:.,..
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<br /> • State,License Na�ber Describ� WorY to Be Done
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<br /> : . �'� tapiration Dat� � _
<br /> � .,1: - � • SSETCH PLOT PLA'7 BELON' .. • _ ' • • •
<br /> ' ':j',:� .� .: , : . : � Ore of Buildinq
<br /> ` - • • •�Hew ❑1lddition ❑ Repair/Remo::el
<br /> a' i . ' ' . �' c`a= .
<br /> • :� . {/aluation of Construction $��.
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<br /> ; •� .. • • .• _ I . PIAT PJ.Ati REQUZR&`IENTS . , c��
<br /> .�,�• . . - .'.- :., , . . � � � • • �
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<br /> � , � . ; • , • . � ' IL�icate lot size, nane of stre-ats,
<br /> •indicate location and width o:
<br /> � � �'. • 1 j•� alleys, locate proposed a.^.d all •
<br /> ' ' . .' � - . ' i:� ' ._ �.. _ , ' .
<br /> - . - �� • existing bnildi:qs, shoca dis;ances
<br /> ' '' ' . �+ to pzoperty lines, show distances
<br /> • .� ►•� , - ' •�'::� ' y'. . � , ' • ' beiWeen buildings. , '
<br /> �. � • • -. •
<br /> � S
<br /> . Lot size �_x �i - _
<br /> :• ' • ' . . . Lot � Sq. Ft.
<br /> , � , , azea
<br /> . • � 3.i' . • . . . � . ' . . Sizc of Bldg. So. Ft.
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<br /> • r.. • � • . � • Numbcr of Stories
<br /> . . a�� :. . . • .
<br /> � . gasement
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<br /> � ��•.�- - , � � ' . . � Signed By/ f� . � i���
<br /> �•:. . . . . � ' � . ' � /a / �7
<br /> . ;; - , . For �
<br /> • - � . ' • pianer . Phone
<br /> • • ' DO :10T h'.i?T5 D-'.LOS�7 TNIS LZ:7E-r'OR CITY QS OiIL'I � �, �
<br /> Datc Seceived � Uce• Zone �__ •
<br /> ' Plan Chec:•..:7ur.Ser ' ' Fire Zone • _
<br /> . Valuation Occnoancy Grom, T_
<br /> � pemit Fee � ' � ' �Type of Cons`.xuction � �
<br /> Plan Check Fee � _ Oecupant Load �_.
<br /> , � Total Fee Due Sprinklcrs Required �_ ,
<br /> Date Issucd � • ' • ., ' ' ,�� ' . . . , ,
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