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BUILDING P6RMIT nPPI.ICATIOC7 /�`" �� . <br /> i Applicant To Complete This Form t��j , <br /> � <br /> If more than one building is to 6c conslructed, suUroit a scparatc permit ap- � <br /> plication for each building. A separat� permzt will be issued for each build- '. <br /> ing. <br /> , Osaner�,��ro �/. Suilding Address �� �( " � S� �4+tc{' /i��` � <br /> � � <br /> Address�L�• �,�� �/ 7 y Lot1L nik. � p" Sec. <br /> CityY�,.�.�:,.cv'� Phonc ,j J'j�/S/ RZvp, gge, � ; <br /> Architeet _ • _ Subdivision (Plat) �,(�.,u. Cf_t•,�Ct ��,G(,lc,�, ;(„ �-,k„� <br /> City Phone Mc�.es 6 i3ounds (Unplatted) <br /> Contractor (��,L.t�...�.p �� . <br /> naar�::s ./,��,y�.� <br /> City `L��.�L� 1'hone337�-3�� I Building Use ,�{�:�vt--� <br /> State License NumUer�,�j-�'/ — I �= ��- �' Uescribe f•7orl:^to De Done(���,.v,�,tc�_�•� <br /> £>:piration Date C'S— ? 3 — 7J^ .-r..� �.c•�ti-�-- <br /> / <br /> `_ %e � � . <br /> [ <br /> ��----- <br /> Use o IIuilding��_�C„ti.c� �;xc ��,-,:.• ' <br /> , �I � i ,r-New . Addition Repair/i;cr,�od�l <br /> � I � Valuation f Construction $ <br /> � . I _ _' I <br /> P7AT PLTu4 <br /> - ' � I I Ind:cata lot �ize, nane o: strcets, <br /> + _ <br /> i indicatc locatiun and �ridth o: <br /> I'� i� � �� �L' allcy:-., locate proposed and all <br /> - ' 6� � existing bui�dings, show distances <br /> — � � ` � to property lines, shoe• dist�nces <br /> �r !1I' � �� bet�men buildings. <br /> � W � ' <br /> �•. <br /> � -- �� � Lot sizc C� . x. /_5 � i <br /> �; Lot arca )r;;S S- 3 s.l'. <br /> � <br /> i <br /> ��. .�___�S siZ� of �ioy. —s.r•. ; � <br /> I •rn�•c�L � :. Numbcr of Stories <br /> ' � Hasement <br /> `" � � llsc 2one <br /> 1� I <br /> -- f�,��---� �- . .--- Signed IIy � i � <br /> ' � ror I <br /> �..1/r+-L;-y— <br /> Owner <br /> . DO NO/T I�RITI: IIELOlO TllIS LIGL'-FOR CITY US� ONLY <br /> Date Iieccived '�JI� .� Pirc Zon . .`� <br /> Plan Check Number � 7 S /7/ Type of Construction <br /> Valuation �j�2 (�("�c� Occupancp Group <br /> Permit Pee / `;;� (o . Occupant Load <br /> Plan Chec3: Fee �.:�i. CG :� Sprinklerc I;equired <br /> Tolal Fce Due . <br /> Pcrmit NumUr_r � <br /> Datc Issucd <br /> � / <br /> ��t �d �{<</�i�c, �3/Z4,�1' APPRpN�p FOR �UILDING P[R�11T <br />