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BUILDING PERMIT APPLICATION <br />Applicant To <br />Complete This Form <br />If more than one <br />building is to <br />be constructed, submit a separate permit <br />application for <br />each building. <br />A separate permit will be issued for each <br />building. <br />Owner <br />Building Address <br />Address <br />Lot Block <br />City <br />Phone <br />Subdivision (Plat) <br />Architect/Engineer <br />City <br />Phone <br />Metes & Bounds (Unplatted) <br />Contractor _ <br />Sec. Twp. Rge. <br />Address <br />City <br />Phone <br />State License Number <br />Expiration Date <br />Building Use <br />Describe Work to Be Done <br />i <br />Number of Stories _ <br />Basement <br />New Addition Repair/Remodel <br />Valuation of Construction $ <br />Signed By <br />For <br />Owner Phone <br />Date Received <br />Plan Check Numb <br />Valuation <br />Permit Fee _ <br />Plan Check Fee <br />Total Fee Due <br />Date Issued _ <br />Do Not Write Below This Line -For City Use On <br />// o <br />Use Sone <br />Fire Zone <br />Occupancy Group _ <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />