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<br />'� � 1t ' ' � ' YSOILDING PERMI2 11PPLICATION � � �.� ,�;;,,:TJ
<br />- ' " + ' , , • : Applicant To Completc Thi� :orr.t � ' �� �-l' :�
<br />.. . ; . , t •
<br />�13a/�
<br />, • Yf more than one buildinq is to be contructed, submit a separate permit a�?p ica-
<br />.. ;top for e�ch 6uildin�. �1 separ�te permit will be issued for cach buil ing.
<br />, " � Qmer % ���`�� .}'� ,�a a � IIuildinq Address ��-"! �c � �
<br />, . .
<br />, • ��
<br />, , 2ti. ress �%�%,- �,�/� f' ,Z>o,P� Lot� .'IS•iHis; /�L Block 7.3-�.
<br />- . City � VC'i Phone �SE'• ?''-�/� St=bdi4ision (Plat) /_� G'�j it'6'/� �
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<br />, ' • Architect/Engi.^.:er �. �_ �Lfi� �_a��t�
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<br />_ _ ._i City (�/ y ,v/ j�%/� Phone � Me�es 8 IIounds (Unplatted) _ •
<br />�;,�: Cantractor �ri���i'L.n T1"i.l dl�/P/Pi3mti Sec. 1Y�rp, Rge . . .'
<br />. ...� . . .
<br />_••� ;..:• 7sddress S-3oJ 3� J E U�" Lv•. ' • .
<br />.'� City _� Uh"/�/,.'J% Phone ;s's'�S�%3,2 SuiYdiny Usc d rF/C/'. C' �/+ . .� -
<br />•i� ._ � . 1 � ,.,•-,s_�:::�
<br />�";•1 � State License Nuaber�� �" ��^���.% ° Lescribe Wor}: to Be Done �r _/}� AN��*.~
<br />� : • .i Ezpiration Dat� �,(� � /% 7 � � n�rR r,:t'a /�' Y N !t� iJ ,-Si✓/�/N y .yt �
<br />�� ' � • • SRr:^'CH PLOT PL;v� B£L0I4 � • S�� %�S '
<br />�...�� " • ' , •
<br />. . • � • .. . . . . . , iTse of Buildirig •
<br />� � , .
<br />�-' � � . . .,. � ' �New ❑ Addition (}�Repair/Remo;:el
<br />• � i� " . . i • 'Qaluation of Const=uction $ ' � �j��d '.
<br />.e _. I . .
<br />-�••.- • �. •�.- � . _ �. � . PIA2 PLAN REQUIREI•SE;7TS
<br />.�, . . . .. _ � . . . . .
<br />� � . . . . . .. e -
<br />�- ; ' � ' . ' . ' ' ' indicate lot size, namc of streetc, �
<br />•� . , . . ..
<br />� • . .i ._ , - � �indicate location anc width of �
<br />• . _ , �_:� .. _ . allcys, locate aroocsed a.^.d all
<br />, i,. .
<br />• _. • , exi.�ting buildir.gs, she.a distances
<br />. :� - ••�''' -'"'! : . • ' • • - ' • . �o property lines, show distances
<br />' � : � ' - , betwcen buildings. .
<br />. . '. . " .. . . -• ' ' • . :
<br />� ; ' , , • . . ' • . Lot size x ' .
<br />. ,�� � . , . • • . Lot area Sa Pt
<br />" �i
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<br />� � Sizc of Bldg. Sa. Ft.
<br />Ntunber of Stories
<br />' IIasement
<br />Signed By T_ �/� -� �
<br />�'or �J,/� . D�,�r,r� � c�n.
<br />� . Owner Phone _'sSs'� 73 ;
<br />..' �_� DO :1(�T SC:2T_TL' ?3F.L0[7 TIiIj LI:IE-?OR CZTY USE OiIL'L �
<br />^_ Date �eceived 4_ /-�_� I`j )� � LYce• Zonc .
<br />—r--�r
<br />' Plan Check, _7ur.,ber 7s'- �j�7 (p ' Firc Zone 2'
<br />Valuation ��, (o(Q�I, �O� occuoancy crou� � -Z
<br />Pcmit I'ce ( (9 � . � ' Type oi Construction ^ j7 - � �.{ (Z ,
<br />Plan Check Pce �
<br />�7•�'^ Occupant Load •
<br />. � 1bta1 Pce Duc ! � I • � � SPY117YXCL_^. Rc cd ' �
<br />. � � • ���' OF �
<br />Dacc Tssucd `�'/_3C� �` � ' /iPPRQVED' FOR"[3JIILDING PERMIT
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<br />.. , . 'Uate'-1-�.Z9-�-��,_F3y�� c
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