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__ ' ; , ' . ' . ' � ' � BOZLDING PEFiHIT APPLICTTIOti � . � , ��e�-.•7fo � � :' � '-'
<br />�:, .
<br />, , Applicant To Completc This :orm /% ` �. ,• /� • j��
<br />; � �. �6
<br />, • ZL more than one buildinq is to Ue contructed, s�iUmit a acparate permit applica-
<br />.: L1on for e�ch buildin�. .1 separate permit will be i�sued for each building.
<br />(�� �� n ��1
<br />. ,��°er -LA', r� l, c �: <\u ����.�� Huildinq Addres� !j�, ���71`1 ] 1,/] h V� d.l;�j
<br />, • �-�.,
<br />•; Address �l', Il.e,n�ClY'o�� I.�'il Lat �� Block '
<br />, . City �+� Phon���`l�-� '� � Subdibision (Pla�) _ � � �1 P ,� �(1,•�(�.
<br />: ' = lltehil:ect Engineer • : , . ,
<br />• °+ �� "'� City �^phone Hetes G IIounds (Unplatted)
<br />_ . ,.. .=j � .
<br />;,• Cantractor 2�t�'lC �' d"�e � ��i0� � .riec. 1WP, gq� ,-
<br />_ � ,
<br />�• , .`' Eddress e '. ; f,� '1@`+ � ' G
<br />�������(� �
<br />. �•' City 4 "1'.��_ Phore .. o ,�) Bvilding [ise .'.�•, ��'
<br />'41 � • � . . _;.
<br />�'�f � State.License Ncnber �?�-(^��_���.�g Describe Work to Be flone ��' �
<br />. �'• . - r u r ' .
<br />: ''i Ezpiration natz c�- �-�%�., '�lL� tc� - l �ttrcn.� n��'1� .
<br />` 0_ 1� CU
<br />��' � . • SP•GTCH FLOT F'LAtI II£LO[4' • �-��� to C' �� (����rnC'�f1�V '
<br />- ••J•:� • .. , . .
<br />: : � � • , . • ULe 0£ Buildinq L�;.`Q�,y�] '
<br />�' ; � , � � . � . ,,, � � �I7ew ❑ I�ddition �Repair/Remo�el
<br />. ,; � • . : +I r- J. oo :
<br />i ' .•; � Valuation of Construction $ y-
<br />.� .. .. ' - � _� I . .
<br />" ' - � � � �� - - PLOT PITN REQUSRE:�SE;7T."i
<br />� , . ... , .._ . . � . � -
<br />� � . . . � �
<br />,-i ' " � ' � _ .. ' � ' � ' ' Indicate iot size, nane of s:reets,
<br />� � �'� ' ' ' � " 'indicatc loca�ion and width of
<br />' • i � ' . �•' ��^ .. . � • alleps, locatc vr000�ed ar.d all �
<br />, ;. . .
<br />1 existing buildiags, shc•.v distances
<br />_ 1'� •..- - --�! ; � . � . ..I:• ' . . to property lines, show distances
<br />� : ' � ' - betwecn buildings. .
<br />; _. .
<br />. : - ' . • . � : • � � Lot size r.
<br />� � �:.i' . � . . . � • � � � Lot '
<br />:
<br />�• r.
<br />1
<br />. • :; , j�
<br />i.. '
<br />+` .
<br />i
<br />. � _ area Sq. Ft.
<br />. ,. � " �• Size of IIlc:q. Sa. Ft.
<br />. . ' - � ' 17umbcr of Stori.es
<br />� , � . • � ' ' IIasement �
<br />Signed-By L
<br />. C
<br />For� �_�,"�����.�L�61 _
<br />' Ocancr Phone � �•-
<br />.� no �oT {iZ_TT� TJF.*OF7 Tt7I5 LS;dE-POR CITY USE OiIL'L `
<br />Datc ^eccived � II�e 2onc
<br />' Plan Chec;: :7ur..Ser '
<br />Valuationl� ���j�+ti. C�'
<br />Pemit rce
<br />Plan Chec1; Fce
<br />ibial Pcc Due
<br />Da[c Issucd
<br />Firc Zonc
<br />Occunancy Grou�
<br />Typc of Con�truct:on
<br />Occupant Load
<br />Sp.-inY.lcr: iicquired
<br />. . . �
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