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e <br />' •—L <br />r � ' BOILDING PERMIT APPLICATION � � ����C;�.�J ��^',{j � <br />• : 7lpplicane To Complete This ?orm � // � �/�s/�� <br />2f more than one buildinq iy to be contructed, submit a separate permit applica- <br />tion for each building. A separate permir will bc issued for each building. <br />Omer � 7"/ta A?� �O �1 ni $::. � Buildinq Addresa r, ic> >-\ C�; J�r- ��l�r- c�� � <br />l�ddcess �� SC? � � .S�/n/>�! /t�i-�'�-.�Lot J � Slxk C";c� �� �+`� ' <br />T . <br />City ��,ror� p l-j' Yhone 3SS = S i��'Subdivision (Plat) <br />Architect/Engineer • — H/l d � i�^� �� � �"��^' � � <br />�—� <br />City �—� phone _ Metes 6 Bounds (Unplatted) <br />� /� � <br />Conlractoi• ^��.�5� v( a, rrJ-�N/ %�c_ (�,c.� See. ZVp• R9e <br />1lddress �•7 r� .- '1 / L � c,J , : <br />. / �. <br />City l I•.•� Phone "J 7( ",,Z ��i Buildinq Use i�c' <� C� �:�� c�z-' ": �,�: ,. <br />.. �,. . ,..'. <br />SWte.L cense Nw�ber l- 1 3�- />'2 � 3��•�Describe Srcrk to Be Done <br />Pzpiration DatE - ������ / `'�"�"��J <br />. / - <br />�' <br />S . ..,�:: . <br />� � ,O`�-�a^� �. . . <br />� � . �. <br />�,,, _ �G <br />- ��/- •. y � -f--d'� . ''-. <br />... ,� . <br />� pse of Building <br />� [�New ❑ 7uldition Q Repair/Remo6�el <br />,� c <br />Valuation of Construction $.7 �b � <br />�� : <br />P7AT PLAN REQUIRE}L:1TS ,j % ' <br />c o^...r <br />- Indicate lot size, nane of stree� <br />� 'indicate location and width of . <br />� � alleys, locate proposed and all � - <br />. existing buildi�gs, show distances <br />��. to propezty lines, show distances <br />. between buildinqs. <br />' . ' Lot size x <br />� . � . ��� Lot area Sq. Ft. <br />^aizc of Bldg. Sq. Ft. <br />r• d- 1lumber of Stories � <br />i' / //��� Basement <br />�? O ` ✓" .. � �� qned 9y � ..Y� i� � <. <br />� <br />��� �� <br />V <br />� ➢O :70T Si:iITS H_I <br />Datc ��ccivea �/S 71� <br />Plan� C:�eck :7ur..Scr <br />� <br />Valuation �G`� U <br />Pexnit Fee <br />� . `�-�- <br />� -Plan Check Fee <br />� a� v <br />� Total Fee ^ue j' `� <br />' Datc Issued �� 1 <br />For j ^ ' -�,,,, <br />Own Y Phone `� % -• - /.�' <br />CZTY <br />Dce 7.one <br />Fire 2onc <br />Occuoancy Grou� _ <br />Type of Construction <br />Occup�nt Load <br />Sprinklers Required <br />