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BUILDLNG PERMIT APPLICATION <br />A li.cant To Complete This ^orm <br />..pp /���� <br />If more than one building is to be contructed, submit a separate permit applica- �/"`�5�7� <br />tion for each building. A separate permit will be issued for each building. <br />c o <br />Owner , �1lQQ��I�^�� ������� ',ti� Building Address ���- =�:�1 �+��� C�����F.;'�-C_- <br />� ` Block <br />Address .J�.�, '� 1__�, � �, �:.��(", �. _„ Lot �,� �� <br />c.L � <br />�� - �. A� � c. .� <br />1- �'� 1 gubdivision (Plat) _� �<< �._�c� � � <br />City� ��P�l[�� Phone_J��- �i..,�` —r- :� <br />_ . I1, � <br />� t � C�.1 C_�`. <br />Architect/Enqineer � <br />City � Phone �- -___ Metes 5 Bounds (llnplattedl _ <br />[� � o <br />wntractor ( l ��:1' ���' '�>� f � �n`�� � �.'% _ Sec.__ '�P. Rge <br />y� / �� <br />Address � �I��l�� �l �l' ZnJ�1:C 11 �_l-r1 �-� <br />� � <br />Citiy�.��`�� f����Phone����- �. � Building Use � <br />State License Num'�er l�c�{.,'�Z� �- �� 7ca �3� Describe Work to Be Done � <br />Expirati.on Date t--�`-�� �l _ <br />SRETCH PLOT PLAN BELOt4 <br />._ Q <br />� i � �,� ��v — . <br />L�C�� <br />. � ti��� <br />�l <br />. r <br />tlse of Building y� �'��-ti� c <br />[,New ❑ Addition !3'ttepair/Remodel <br />�. <br />Valuation of Constructicn $ �(�(`,C <br />FTAT PI.AN REQUIRE"SENTS <br />Indicate lot size, nacae of str=ets, <br />indicate location and width of <br />alleys, locate proposed and all <br />existing buildings,.show distances <br />to property lines, show distances <br />between buildings. <br />Lot size X_ <br />� Lot area Sq. Ft. <br />� Size of Bldg. Sq. Ft. <br />� Number of Stories <br />Basc�ent -- <br />� <br />Si4ned Sy \ �,.'_. �� �� ..,� �.� <br />For <br />Owner Phonc <br />DO idOT Y7RZTG BELOl9 TFiIS LI:iE-FOR CITY USE Ot7LY <br />pztc ^cceiccd _ _ _ U-e �one <br />P1an C`ecY. Vunber <br />Valuation <br />Pemit Fee <br />Ylan Check Fee _ <br />Total F^_e Due _ <br />Datc Zs�ued _ <br />Fire Zonc <br />Occuoancy Group <br />Type of Construction _, <br />Occupant Load . <br />Sprinklcra Recuired _ <br />d <br />CITY C�= -';"`;�-1`T <br />ri�F'I����LU �Ui? �+,,;L�..i�.�,i i�/i:������1 <br />o,�.�_�ltz /� .�� , ��,,.�1.��,C��.;�..���.�. <br />