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BUILDING PERMIT APPI.ICATION � � �� `� <br /> �i Applicant To Complete This Form <br /> If more than one building is to be constructed, submit a separate permit ap- 3/J�,/ <br /> plication for each building. A separatc permit wi21 be issued [or each build- <br /> ing. _� <br /> Owner � (�- �� Duilding nddress�J�>"�y�(2��;a.� /� ���-r-� . <br /> a 55' G <br /> Address L� Q � _ Lot?�Gi-� Blk. / � � Sec. <br /> City - Fhone 7Wp.._ Rge. � <br /> Architect ' � Subdivision (Plat) � �_ s — ���i. � � <br /> City Phone Metes & Bounds (Unplatted) � <br /> Contractor ' ..�-.--,('.. �� <br /> �d n �'i-�.�� - <br /> Address�((� d�t�/ S %� � <br /> City (d_�.q�����n�� � Phone 7%�i- -%1'// Building Ose <br /> � ,� i <br /> - State License Number"'� �=:� 1 --l�r 6/ Describe l9ork to IIe Done'��y���u-`�v].��-..� <br /> Expiration Uate /�=��,�-�ti '✓�l�'�!C� ���,.�4�� �'T���: .1,. .!�• � / <br /> � 7� —�� . <br /> . :,, ,��,���.�c,.�)��� <br /> � Use of �uilding ` - <br /> , '—New :. Addition Repair/S:enodel <br /> .� O"2� <br /> Valuation of Constructi,on $ � �� <br /> . � - PLOT PLAN <br /> � ' Indicate lot size, name of streets, <br /> - indicate location and wid;:h of <br /> � alleys, locaY.e proposed and all <br /> � - existing b�ilflinys, show distances <br /> to property lines, show distances <br /> � between buildings. <br /> Lot size x � � <br /> Lot area S.P. � i <br /> . � Size of llldg. S.!'. ; i <br /> Number of Stories , <br /> llasement <br /> Use Zonc� _ <br /> '// <br /> /. <br /> � Signed IIy,/ • /�e7�i , <br /> ror , <br /> Owner I <br /> DO 1dOT Y7RIT� 1313LO19 TI3IS LINli-FOR CITY USE ONLY � <br /> �- I <br /> Datc Recei.ved � � �7 S Fire Zwie <br /> Plan Check I�umber � Type o� Construction <br /> Valuation 1���U •c'�' Occupancy Group i <br /> Permit Pee ( d �J Occupant Load <br /> Plan Cl�eck Pee_ Sprinklcrs Required f <br /> �� ' ".,.. i <br /> Total Fce Duc � . <br /> Pcrmit Numbcr - . <br /> I <br /> Date Isaucd �%�j 7� . <br /> ��- <br /> APpROVL'D f-OR QUILDING P�RMIT <br /> n.,�� <br />