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/��'� s� <br />BUILDZNG PERMIT APPLICATIOY <br />� , Applicant To Comolete This ?orm <br />� � <br />If more than one building is to be contructed, submit a separate permit applica ���/%` <br />tion for each building. el separate permit •di21 be issned for each building. <br />Owner � !y Q�}N�vO�d Building Address <br />p/� src AY dc/,Cc/ S�F'c'2� <br />Address p�Q. (J� �{2cg Lot_� Hlock <br />CityMk�L'r�j�p w�phone 3 �� —�I7S Subdivision (Plat) • <br />— ' wy S�%¢ <br />Architect/Engiaeer K / � �Q Y _ ..��'�_d aio ,cra a7 ,� �a � G, _Z�_ <br />City Phone <br />Contractor 1�, ►�J. y,�y4 N�/ v0/� <br />Address /"• �• l,.�pie 7 Z S <br />City/�'(t./Li���'�/'rPiione �.t�—�%35 <br />State License Number �^�'3'�/—/a5/d <br />Ex�,iration Date 4 '�— ��� <br />SRETCH PLOT PLAL] BELOW <br />80� <br />�.OT Sl2E <br />�a, SDU ¢S <br />_ MlN. <br />A <br />4 <br />r <br />N <br />� ¢� <br />\Metes s Bounds (Unplatted) <br />Sec. �� 1Wp. a.9' Rge E��f1�N/. <br />Huilding Use S�(C /¢,j/ / {� CS/o"e+(J�. <br />Describe Work to 9e Done <br />Dse of Huilding _ <br />�New ❑ Additio:� ❑ Repa.ir./Remodel <br />Valuation of Cons�ruction S o�e� .� C O <br />PIAT PI,AN REQUZREh1E[7TS <br />Indicate lot size, name of str=ets, <br />indicate location and width ��f <br />alleys, locate proposed and all <br />existing buildings,.show distance=_ <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />� Size of Sldg. Sq. Ft. <br />Number of Stories <br />Base, nt _ <br />\ <br />Signed B <br />t'or <br />Owner Phor.e <br />DO NOT WZITE BELOS•7 THZS LI:IE-FOR CITY USE ONLY <br />Datc .�ceice? _ <br />?lan Check ^13T�r_r <br />Valuation <br />Pernit Fee <br />Plan Chec}: Fae <br />Total Pee Due <br />Datc Zssue3 <br />�,������ <br />,�-� -�¢ <br />� <br />U�e 2one ��� �JlW[ 7ZWl ^a�) �-",S, F�S. <br />Fire Zone #,� ' <br />Occunancy Groun <br />Type of Construction <br />Occupant Load <br />Sp:inklers Reauired <br />�+� ` n rvr .�'�'� <br />�nr:' ' � . <br />, �, � � � . :c: r�rn-�rr <br />�,F <br />f�,. <br />