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��C!� IIUILUZNG PERMIT APPI.ICATIOI4 /�/ /� <br /> , Applicant To Completc This Form � <br /> � , 3�'/�s <br /> If more than one building is to Ue constructed, submit a separate permit ap- <br /> plication for each building. A separate per.mit will bu issued for each build- <br /> ing. <br /> '� f 4_ :1�..} . <br /> � :'. �1�'� ,�,(s'17/�C <br /> X Owner__J�'/�i�/ !� !i�. G����� }3uilding p�dress �i , , <br /> /� . �•}'7 <br /> Address��0� , P i� �.�ef � - ) �' Y�,c'� , y ! �,,; �'�.- <br /> �.,.� i �G 1.'/, . Lot (lllk. ��', Sec. !�/,•�' .-C,a� �`,�',� e "� .� <br /> City .rL�� � C' I I' Phone. 5 >' - �`��`i R1ap. Rge. � � <br /> Architect — • - Subdivision (Plat) <br /> City Phoro Mr4es & IIounds (Unplatted) <br /> Contractor <br /> Address <br /> City_ � Phone IIuilding Use <br /> State License Number ' ' Uescribe Wor'r, to IIe Done . F.��%'�i /�/J-/_ <br /> Expiration Date �j�j D�Cy. !�� S <br /> - -- - -- <br /> - N �T�S�-r��" ~ , 1? � _ S usc of suilding � <br /> , ` �� _T '-New .. Addition Repair/Fencdcl <br /> ���_l�-�� � <br /> � � , +�-n Va7.uation of Constructyon $ <br /> .y <br /> �I. . �� � � PLOT PLI�N <br /> !�l v �� ,�;�� � <br /> ;;T � � Indicate lot size, name of strcets, <br /> �' indicat:e location and laidth of <br /> -' - --- �� � alleys, locate proposed and all <br /> � - . IT . b � existing buildin9s, show distances <br /> a � to property lines, shoi. distances <br /> `Y � between buildin s. <br /> ks y y <br /> . 4- y a ' -_'9 r.oti siZ� X � <br /> � � . � Lot area S.F. ��, ,� <br /> � Size of 61dy. S.E. � ; <br /> NumUer of Stories I <br /> Uasement <br /> i II� Use 2one <br /> � 1 � <br /> . . . Signed llY '�a �i. r , �1��n�ti1 I <br /> i� <br /> y� ror c i <br /> Owner i <br /> DO NOT WRITP, DELOl4 TIIIS LINE-F'012 C77'Y USli ONLY i <br /> Date Reccived �J��/- ZS Fire Zone <br /> Plan Check tiumbcr • Typc oi ConsLrccCion <br /> Valuation - Occupa��cy Group <br /> Pcrreit Pce 3(.� �,, Occupant Load <br /> Plan Check F'ee Sprinklers Re9uised <br /> Total 1'ce Duc 3Cd � � . <br /> Permit Numl�cr ' � <br /> o,t� i55��a a-/� 75 `'- 1 " _ <br /> � �•.� ��'�75 <br /> APPROVED fOR QUILDI�'G PCRMIT <br /> o.,f� <br />