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__� � BOILDING PERMIT APPLZCATZON ''i � <br />; �/ ,.� <br />� , . � , 1lpplicant To Complete This Sorm � � `j ,� v ���.•, <br />. • Zf more than one buildinq is to be contructed, submit a se arate �^/�/'� <br />•. tion for each buildin p Permit applica1 <br />q. �l seplarate permit will be issued for each bui/lding. <br />. "� Oimer �E P� � � S� r1'1 .� y, n i I,, Buildinq Address �-/Z I -/ �� 1' SiS 5 i,�' <br />. � , Eddress "Z/ �O � S! . Sc��_ y�t Blxk . <br />, City (_ ,'p 2c 1 i Yhone� 5� !-��� 1 Subd.ivision (Plat) : <br />_ ' • ]lrchitect/Engineer � <br />. :, ' :- •i ' <br />__ _i City Phone Metes s Bounds (Unplatted) <br />-. :, Coatractor Sec. . <br />. '1�p• Rge <br />_. . . , 2ddress ' <br />', «ty Phone Building Use � <br />;. � �, . •�::'. <br />• . � j State License Number Describe Work to Be Done o,,, r l'c_� .�'' � <br />: � ��i Ezpiration DatB � r i-., � . ;..i.� --�,, - ar , . � . <br />. . 1 1 J <br />��, �� . ' SRETCH PLOT PLA.N BELOT4� • - <br />. , ' i . . <br />•f . � Ose of Suilding • <br />� • .. -; � .. �New ❑ Addition �'Repair/Remo�el <br />' . . � � � . . • � Valuation of Construction $ lL�nO � �' <br />0 <br />...r, • , . � ' • . . <br />� <br />. <br />- y : . . . <br />� � . <br />DO :10: <br />B°LO[7 <br />Date �eceived , (� � ) <br />� <br />Plan Check :�ur.,Ser �`� <br />Valuation � J <br />(.P n�J Q— <br />Peznit Fee (p • ` U- <br />Plan Check Fee , <br />�v <br />1bta1 Fee Due �O� `� <br />� <br />Date Issued __• _<? f> S <br />. �. . <br />. PIAT PLAN REQUIRF.tdEyTS <br />� Indicate lot size, nane of streets, <br />indicate lncation and wicth of <br />alleys, locate proposed ar.d all <br />existing buildi:gs, sho:v distances <br />to property lines, show distances <br />between buildings. <br />I.ot size x <br />Lot area Sq. Ft. <br />Size of Hldq. Sa. Ft. <br />Number of Stories <br />Hasement <br />\ r� <br />Signed By �)G mn,,J, �� ;! v, - r �\ <br />c-�-�=--- <br />For <br />Ocrner Phone . <br />f£-POR CITY US'z Oi7L'! <br />U:.�e� Zone <br />Fire Zone <br />Occuoancy Grou� <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />