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<br /> � � � � BOILDZNG PERMIT APPLICATION ' - � ''"�.t
<br /> . Applicant To Complete This ?orm �c�� �'�G E
<br /> , . ;1"�';�7-,-
<br /> � '- L morc than one buildina is to be contructed, submit a separate permit applica-
<br /> S:�on for each buildin3. 1� separar.e permit wi11 be issued for each tuildinq. ,
<br /> . . ' :j . r� ; ,-.�C ..i !. ,
<br /> w ��r ;!- �" ' � ;; yj��,.,,__ Buildinq Address j • '
<br /> . , �
<br /> � r1 ✓ / .
<br /> , �dAress �,?c - �'�til-'.���-` �n Lot� �� .� � .,..-� '� Block
<br /> City �,>� Iy' Yhone ����-4'�,',• Subdivision (Plat) „�y �e-. •
<br /> ' - Lrchitect/Er.qineer •
<br /> �"� City Phone �_ Metes t Sounds (Unglatted)
<br /> • � ��:�� �li;-�1�,.�.e'�ti Sec. T+P• Rge
<br /> :� Contractor -- , .
<br /> ✓
<br /> .. �ddress /_�., � �l=�/_1i..L�..� 1�, . �
<br /> - r �tiY �u�,{�'" Phone �'r ,--y.f�n Huilding Use �1'�` -.'=''. .
<br /> :.� , i'`�C�
<br /> '" � State License Ya�aber � ? s'- r '_ /7 3'�i �scribe W�rk to Be Done �..i---� _
<br /> �_ _, .
<br /> . ' `� �
<br /> , . . ' .t Lapization �at� r� - /- 7 S � (�° _.{;�...�.,�.��, -` - -
<br /> �� � � . � b10ETCH FLOT PL� IIELOi4� ' . ' .
<br /> . " ' I . Uce oE Building _
<br /> ' . I s � �
<br /> � 1 yJ'-i2-� %��?`"� • � (�New ❑ Addition ❑ Repair/Remo5el
<br /> �. . .�" . . � . �,
<br /> . . ' . Paluation of Construction 5 ,��[', ('-a"'
<br /> . , . ' � . ' . PSAIT PLAN REQOZ:�tE.�lE:ITS .
<br /> �'. , . . , . � . .
<br /> . � � . . � Indicate lot size, nane of strcets,
<br /> � �,• � ' . ' . ' � � � �indieate lecation anc width of
<br /> j .. , , � � allcys, locate �roposed ar.d all
<br /> � � .' - • existi.ng buildir.gs. shov+ distances
<br /> - ., .' _ .. __ y : , , . . to proper.y lines, show distances
<br /> . . - bctaeen buildings.
<br /> � � -
<br /> , � " Lot size X —
<br /> � • . ' � Lot area Sq. Ft.
<br /> .. ' . � Size of �.dg. Sa. Ft.
<br /> • .. ' Numbcr cf Stories _
<br /> � .
<br /> � Basenent
<br /> , .; . i /
<br /> :.. , . Signed By _,C/ � / %� ��a `„".-
<br /> ' � •' ' Y'
<br /> ;, For �.lj s,'��� �"� .
<br /> . . Ownez � hone :� -� P- :�
<br /> � DO :70': 5�3:.T� BELOh7 THI� LI:iE-?OR CiTY USF. 0:7i'L .�
<br /> Date c-ceived 7/�`r U:.e Zone ��- ' 3 �
<br /> • Plan C:ieck :7w:.ber 11
<br /> 7� - Z�1� Fire Zonc 5
<br /> Valuaiion Occunancy Grou� _ ri
<br /> Pemit Fee '_ Type of Construction \I ' 1 a'� R •
<br /> Plan Check Fee Occupant Load � -
<br /> � 1bta1 Fee Duc __�_._ Sprinklers Required —' �
<br /> . �, .� . , , : .
<br /> � Datc Issued - � �' . � ' - . � �
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