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- - - - - - - - � - - <br />_ _._ ._. <br />;:,. , - - --- ---- ..._ <br />�� .��." -' BOILDZNG PERMIT APPLICATICN / (i �(J �f <br />. �-- Applicant To Complete This ?o=m d ►� <br />If more than one building is to be contructed, submit a separate permit appli�a"- // <br />tion for each building. A saparate permit will be issued for each building. �� <br />�eL ��'� ���L�- /�/� J2/L/S/�Huildinq Address �1/�y� �'�/J ' / <br />f%Z/� � �� � <br />Addzess _ � /J���'j,��, Lot <br />Block <br />----�_ <br />City _C/,L�,C'E�- phone �.i�s�s,_�j��5ubdivision (Plat) - <br />]lrchitect/Engineer /�%,E � <br />City Phone Metes e Bounds (Unplatted) <br />Contractor . <br />_ Sec. T1ap. Rge � <br />Address <br />City Phone Huilding Use C a}-�fj��' j= .' <br />State License Nu^�ber Describe Work to Be Done <br />Z �'� iZ <br />Expiration Date G�����.� _ ��,��/ �C(�1�� <br />SRETCH PLOT PLAN BELOiP � <br />Ose of Building � <br />❑ New ❑ Addition �Repair/Remodel <br />� ' Valuation of Coastruction $ 2�0 d=� <br />� ' PIpT PLAIJ REQUIREF1E,yTS <br />Inui.cate lot size, name of :reets, <br />- indicatc location and widtL of <br />alleys, locate nroposed and all <br />existinq buildings „show distances <br />!� - to property lines, show distances <br />. � between buildings. <br />• Lot size X <br />Lot area Sq. Ft. <br />� Size of Bldg. Sq. Ft. <br />-��_.._ Numbcr of Stories <br />�. ' 8aser.,er.t ' <br />Signed By <br />Foz <br />. Oi.ner Phone <br />I <br />_ DO NOT {ORITS ➢Ei.OIJ THIS LI.]E-FOR CITY USE OYLY � <br />Dzte _�cei>e� U�e Zonc 'Q 1 <br />I <br />Plan Checc >7crber Fire Zonc �� - I <br />Valuation 2ltSU7�-�- Occuoancy Group �. �-' <br />Pemit Fee �7sb ��l � P.p�„K�"��•�q �.pe of Construction V- F.� ' <br />Plan Checi: Fee i-'�C1 Occupant Load . � <br />Total Fee Due �'t-� Sprinklers Reauired i.� Q <br />Datc Issucd � <br />�'w,��4� i����h �- � � � <br />����1✓f �(?,�1„Y,�iiT%�%�'� rr� i � jJ�� f�'/��i°1/ �F �i�% �t', /�''�, i <br />LL, ✓� I <br />