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!�� <br />_• :' } •. . ... , �. • � DOILDING PERMIT APPLICATION . . . . � .� � , •t� <br />� • applicant To Complete This Sorm ',�� � / <br />' � � ' �//• t)�. <br />� If eore than one buildinq ia to be contrueted, submit a se arate <br />, .• ; tlon for each buildin 11 se arate p P��it applica-„ <br />4• p permit will bc issued for each building. F/, <br />, . � ' OVo!! �ItUt�lQti � �e7.1�y � /,i. <br />� ) "�r,...: <br />' Dnildinq Address � g0�r W e� O�e � y== <br />�.+' �Edress Q0� W�..�I��oHc Lot�io'1� i�ot�'3� Block ��% , : <br />•.�.,• •� atY r�er� Phonz5�d5 11Q1 3ubdivision (Plat) SwQ�W�l�S y�k : � <br />_ � �� � Yrchitect/Enqineer � �1�;�,ieu . <br />. _i . <br />_ � i.; • �=�i �tY phone t�tetes i Bounds (Unplatted) - <br />__ „� <br />' :.' Contractor � i l� � � Sec. ' • <br />..., — 1Vp, gqe <br />�. '. < ..�. . . . <br />� -'•' • �ddress . • . <br />:� . � . <br />..' � «tY Phone Br�Slding Ose . .. ;�:_ s. . <br />Y '? •,t::' . •.r�•.+;+��✓-� <br />y� Slate,License Nmcber Describe Work to Be Done ""�• <br />. � <br />: � .I . bcpiration Dat� ' . � 4; 11 .�� . :. <br />L�. ; . j •. . . <br />SI�TCH PLOT PLA,Q BELOW' = � <br />' •j•�,� •' .•. . • . . ... • • . . . _ . : <br />• . � Dse of Buildiaq <br />� + � ,�,�"" • �New ❑ Addition � Repair/Remonel <br />. . .t' �.. {��r..Dk'� • .... �. <br />• , � _ . ;, . � •' • "• � . ` � � • Valnation of Construction 5 CO ' '� • <br />� . . . • r ,�� �_�7 _ <br />�" • ' . • , ^ � PLOT PLAN REQUI?2EFIENTS ' <br />'� � . . �� � � . . . ' '. <br />• • ' � ' _ � . .. • , ` ': <br />•'.�.� � ' � ..P' ' • ' ' Indicate lot size, name of streets, � <br />' � � �� � �' • •indicate location and width of <br />� ,. �,� ' � 'r�s:: : � y' �•:.� I • alleys, locate pronosed and all � <br />•'� •� - .! �•�. •, existing buildings, show distances <br />_ • 1,:t ' �i^� ��-•--•w : --{'; , y , , _ tp property lines, show distances <br />_ � � � � • : betaeen buildings. <br />. `� , : I.. . . -. . <br />�� : _ ;_._:_, � I.J `k . �.�!. � . <br />� . . 0' <br />' � . -` •!"? � � U ' . . . <br />. . . ::0 NO'" <br />�--� —, Date Received ��2 /Z ') l' <br />' , P1an.Cyec� 9ur,ber ' <br />Valnation ' �%(]7y. ��� <br />. . Femit' Fee �'j°, �� <br />.' ' plan Check Fee --' <br />. � ibtal Fee Due � �1� � <br />' _ ' r <br />Datc Issued ' � S 'Z ) <br />s. <br />' . , . � . . <br />• . . .. , <br />bot size x <br />Lot area . Sq. Ft. <br />Size of H q. Sq. Ft. <br />ltumber of Stories <br />• Sasement <br />Signed By <br />For` ' <br />owrner Phone <br />:I:IE-FOR CITY USE Ot7L'L <br />IIte 2one <br />Fire 2onc - <br />Occuoancy Group <br />Yype of Construction <br />Occupant Load • <br />Sprinklers Required <br />. '' ' � � <br />' . . . . • . '. <br />9 <br />