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0 <br />--- � - - - <br />- -� , _. __ . ..� <br />' � BUILDING PERMIT APPLICATION l ����j <br />Applicant To Complete TYiis ^orm � ��/ <br />' If more than one building is to be contructed, submit a separate perrt:it apol/ica�/ <br />tion for each huilding. A separate permit will be issued for each building. <br />r c� C/ / <br />�Owner �• l� •%) ' Building Address /��� J/��/U�T L���� <br />� � <br />Address Lot i<' � Block --- J <br />, <br />City Phone Subdivision (Plat) �'-����= i( c'���� <br />1lrchitect/Engineer <br />City Phone Metes 6 Bounds (Unplatted) <br />/ i '1 % <br />Contractoz ���� � �.f.s �{�i(�( . Sec. i '1Wp.. � Age r' (.� � <br />Address �O lf ? C� � � .C� /Li ,7 ,�� � � . <br />City �/C �'C�f� Phone d��'7- �/ % 2 G' BuilZing Use <br />State License Number ,-1 �- "i i�i� /�.i� % 3 Describe Work to Be Done <br />Expiration Date � " � � � � � <br />SRETCH PLOT PLAN BELOW <br />t� <br />Use of Building <br />❑ New ❑ Addition �Repair/Remodel <br />, i p �� <br />Valuation cf Construction $� � J l, <br />pLpT pLAN REQUIREb1ENTS <br />Indicate lot size, name of st:ects, <br />indicate l.ocation and width of <br />alleys, :ocate proposed and all <br />existing buildings,.show distances <br />to property lines. show cistances <br />between buildings. <br />Lot siz= X <br />' Lot area Sq. Ft. <br />� Size of Bldg. Sq. Ft. <br />' Number of Sto�ies <br />Basener.t <br />% / <br />Signed 9y ,�i� .-[�`i.� _ . � "vi �. <br />�� For /� �( • � - <br />— O�rner Phone <br />DO NOT WRITL <br />Date ^.�cciced ����_ <br />Plan Chec}: "unbcr _ <br />Valuation <br />Pemit Fee <br />Plar. Checl: Fee <br />Total Fe^ Due <br />Da�c Issuc3 <br />O:7LY <br />Ct_e 3one <br />Fire Zonc i_ <br />Occuoancy Group _ <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />