|
BUILDIt7G PERMIT APPLICATION � / �(��"" `
<br />Applicant 'Po Complete This ^orm �
<br />�/���/7 �
<br />If more than one building is to be cont:ucted, submit a sepatate permit applica-
<br />tion for each building. .1 separate permit will be issued for each buildiny.
<br />� `'
<br />owner .,_�, "C� � �10 , C� ��. ��c�� �.-�,:�r-�� � ' Building Address '"�r I-(_ : Vr_i�nv' : �`� i
<br />Address � � � a-
<br />�.�('(`��r .J11 ���vc.� i{'fi �,��, - Lot Block
<br />��i
<br />City �, ��f�,��_('-(' Phone,-'�'j,�-�i���J/ Subdivision (Plat) -
<br />Architect/Engineer i--
<br />City -- Phone
<br />Y ' c _
<br />Contractor �, �i_l�{�- �i�l�����lU°i:� �llQ,
<br />•l
<br />Address rjLC( ,� S�',21)LQsI �l� � 4 1Li�
<br />City�( �4,1C{'�f- Phone ��%3- //(„�
<br />State License Number ,�,�,���j- (i� - � /y�� Q
<br />Expiration �ate („ - �j(��- ���..
<br />SRETCH PLOT PLAN BEi0I4
<br />Metes S Bounds (Unplatted)
<br />/ . —�
<br />Sec. ._i4� 1WP. ,�J Rge '�
<br />Rt - a� D .3'7 l� �
<br />Bvilding Use �.�f�C��-�tt ;
<br />Describe Work to Be Done�`tC���crOeQ (�c�y- ���-�
<br />��,1�'1V�i��t-�L11lCf���f'.17_��[��H'i i�.. �°O'��,�rt�.(;�
<br />i,
<br />Use of Building
<br />� � � � � � � i�
<br />��� �(� � . � ��l_' l �i L`_�� 1", .,;{_ � � �. (<' "1�'._, '_�.1'.�ti� Addition �"Repair/Remodel
<br />/{� oi
<br />\il ti�L� LJ 1`ii,�.. ��_�.Jdl�t��_ 1` �%�. �l��:J... U�
<br />� pd �' c� �- �.G� a � � � ��li ` Construction S �-, n`���„ -
<br />-�C., �;� �E �^�� -l� Y'� �1 olG.
<br />IL� �.i�n.c., ��1��+t, ���0.� d`.�� bc�' -Cc� l� mtan� i xe4oiRar��Ts
<br />�' -��� S Il�,.b�- `� a�' ��-CC'v C� �.v R�"��� `t� lot size, name of streets,
<br />-��
<br />.,',:�� ii9,�a�� ti gg.Yjs'° \jp')l� '}'O 'n-. location and width of
<br />.ocate proposed and all
<br />�,� � �,J���/ �(�, C--L �,1,'•CJLCJ��"vvi. 1-�,'L-�'i�r�� buildings, .show distances
<br />{ �� � . p,; . �1(_;�jC�� rty lines, show distances
<br />111 � � --. "-
<br />�� CC .1 �-�'J.�.�,, ^•�. C`J �:[1\ �y �'_`.- �vildings.
<br />_� ����- I_; '-.
<br />For
<br />Sq. Ft.
<br />31dg. Sq. Ft.
<br />: StoFies
<br />_ ��t-:'�V�`,�'i"�.,.
<br />Owner Phone
<br />DO NOT WBITG IIELOiJ TFiIS LI:vE-FOR CITY USE 0:7LY
<br />Oate �cci^ea
<br />Plan ChecF: `lunbcr
<br />Valuation
<br />Pernit Fee
<br />Plan Check Fee _
<br />To:al i'ee Duc
<br />Datc Iscuc3
<br />U�e .^.ane
<br />Fire Zone
<br />Occuoancy Group
<br />Type of Construction
<br />Occupa.it Load
<br />Sprinklers P.equired
<br />CITY (' _ ._ .,-
<br />n�Pr;oy�„ ;f. _ _ . ,
<br />c:,; . i� 20��
<br />
|