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- - --- — - -- /��{- <br /> HUILDING PERMIT APPLICATION /�7V f/•"�� <br /> applicant To Complete This 9orm �/���� <br /> If more than one building is to be contructed, submit a separate permit applica- <br /> tion for each building. �1 separate permit will be issued for each building. <br /> Ovnei �� Yl�l1�� �l �Y�'ll �v �l� Builning Address ��•(�� ���J`i�tt ��-� ��.� . <br /> Address ���� ���U� Y� ��l Lot �`1� ,� Block /�i - D -00 <br /> � <br /> C�ty ' 1L'`�� Phone � + — ��si� � Subdivision (Plat) � �•�Ch� Rti� a�;i��c, tiUC7r('$" <br /> Architect/Engineer � __ . <br /> City \ Phone �- Metes S Bounds (UnTlatted) <br /> � ,/� u b <br /> Contractor�l �f'lc�� f�l� li�l' � - 1�,Q111C ,Sec. 'h+p._ R4� . <br /> 1 . <br /> Address ��� �'1�Q�'Sl � z�� - <br /> ( � \ � ' <br /> City L' � � � � � Phone: . - �c Bnilding Use � <br /> State License Numbera��'j—�i� —� �"l�<�Ic4 Describe Work to Be Done - <br /> Expization Date (�.— �(� — �J �� L��i h `�'�- ���-�� �='�i �\IYL'�f��-j• <br /> . . i� <br /> SRETCH PLOT PI.AT] BELOtP <br /> � Use of Building <br /> . � G New ❑ Addition ❑ Repair/Remodel <br /> • � ,-,e-� Of� <br /> � � Valuation of Construction $�.yv � <br /> � . PLCT PIJ1N REQUZR&�lENTS = <br /> • Indicate lot sia.e, name of streets, <br /> . i �dicate location and width of <br /> � � a. l.eys, locate proposed and all <br /> - existing buildings, .show distances <br /> � .� . to proper�: lines, show distancxs <br /> ' betaeen buildinas. <br /> Lot size X <br /> � �. Lot area Sq. Ft. � <br /> - Siae of Bldg. Sq. Ft. <br /> Numbcr of Stories <br /> �� Daser,.cat <br /> _ Signed Sy1 — ! <br /> k or ������-'�'L�`/�-) � <br /> Owner Phone <br /> � <br /> DO NOT IJRITG BELOIJ THIS LI:1E-POR CITY USE Ot:LY ( <br /> D�`•, 'ICcc.VCd ULe ^0;10 � <br /> . � <br /> P1an Chec?: :lunher Fire Zonc <br /> L'�' Oc^uoancy Group <br /> Valuation ��, � " _. <br /> Pemit Fee LC ' �� _ Type of Construction <br /> Plan Checl: Fee Occupant Load . _ � <br /> Total Fec Duc SprinY.�_er^ aequired <br /> cirvc,- �-, � _ rr I <br /> �3t� �s,��d Ar�PRov�o ro., . � �,�,ii� <br /> ' i <br /> . r . _ <br />