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, � - � DUILDING PERMIT APPLICATION . j �';P,`:{ <br /> _. . Applicant To Complete This =orm /� ��;!/�; <br /> . � <br /> Sf moze than one buildinq is to be contructed, submit a separate permtt applica- <br /> � tion for each huilding. �1 separate permit will be issued for each building. <br /> . . �ei �' � 8uildinq Addzess $/G/ SE�t��fu� i<'R� � <br /> Mdress � Lot � Block o03 p -J3 ' . <br /> v - <br /> Cit � phone�S-�6`� Subdivision (Plat) .�r4vrEu� /�E`����s <br /> . Y <br /> ' • irehitect/Engineer _ <br /> ' w •_!SO FT n+� Lof � Qs �1fPs Al LN. . <br /> �'•� City � Phone Metes i Bounds (Unplatted) <br /> - - 1 gqe � <br /> � Contzactor � Sec. '�'P• <br /> :� • . <br /> ' ldLzess . � <br /> �tY Phone Building Use ��` '? . <br /> � � <br /> '� <br /> {'� � State License Nc�nber _ Describe Work to Be Done <br /> .; <br /> � . � Lxpization Dat� <br /> .1 : � ' � SICETCH PLOT PLAN BELOSQ� ' � , <br /> • . • i . . . . . � Dse o� Building Q!./'f. fi" S'lpt��G • <br /> . � <br /> � : � . � � � . � � ❑New � Addition Q Repair/Remo::el <br /> '. • . . . , . . . . .r,,. <br /> - . . . 5p0 �. ' <br /> ' ' • paluatiun of Construction $ <br /> ' � ' ' . . . ' . . Y7.OT PLF1N REQUZBE}IENTS . - <br /> -r.- ' .. . . _ . . , � . . <br /> : � � • � Indicate lot size, name of ::treets, <br /> �• ; - ' � ' � • � � �indicate location and wi�^.h o` - <br /> . '. � ' � ._ � alleys, locate proposed a,^.d all � <br /> � . � - . � � � � ' existing buildi:gs, sho•.v distances <br /> . � �'.i � : . __ ,� : : �� : . to property lines, show distances <br /> I between buildings. <br /> • • � <br /> ` ' Lot size X <br /> . ' Lot azea Sq. Ft. <br /> �•• ` . ' Size of Bldg. �._ S4• Ft. <br /> r.. ' � N�cmber of Stories <br /> �� . <br /> Basc::�ent � <br /> %•• ,-• +• Si9ned Sy �L L / t��_ <br /> ` _ . <br /> i For S•l7 i/1 F , <br /> . '. Owner Phone _�_ <br /> � DO �10T lti:iIT' HELOS�7 THIs LI:dE-cOR CITY USE OtIL'1 <br /> � . <br /> � � V Use� Zone - <br /> Da[e Seceived � 7 <br /> ' �- � ' Firc Zonc <br /> � Plan C:ieck :7ur..Ser , <br /> c r <br /> Valva�ion �� ��� �� Occuoancy Grou� <br /> � ' • � Type of Construction <br /> peznit Fee `� ' • <br /> ' ----- Occupant Load <br /> Plan Check Fee , <br /> 1bta1 Fee Due � � � Sprinklcrs Required <br /> Datc Issued '7 � S� . • , ' � . <br />