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BUILDING PERt9IT APPLICATION /��� Z <br />; Applicant To Complete This Form �/// � <br />If more than one building is to be constructed, submit a separate permit ap- <br />plication for each building. A separate permit will be i.ssued f.or each build- <br />ing. / <br />�L�K�+ �/il/�/� <br />Owner <br />� �-/ <br />Address_�����`��/ � �% yy��� <br />��_ <br />City�(/� Phone <br />Architect ---�' <br />City .�_ Phone� <br />Contractor_ ry,s�(/ 7�p�i<T. <br />Address�Q. �"aX 2O�- <br />City���. Phone� ,3i(S", <br />State License Number�.�3�o/��Gpro <br />Expiration Date (� - ! 7' /� � <br />T <br />lluilding nddress_��%����1��%1l� <br />Lot(S�� IIlk.��� Sec. /���_ <br />TwP• ` Rge. -- , <br />Subdivision (Plat)_�p���y��,.f./���, <br />i <br />Metes & IIounds (Unplatted) <br />Building Use�/ �,�y�� <br />Describe S9ork to IIe Done P � <br />�'l. <br />�Q��2 � IL��'--i <br />Use of Building / L � <br />'� New -.Addition epai /Feno el <br />U <br />Valuation of Construction $�� <br />PLOT PLIS] <br />Indicate lot size, name of streets, <br />indicate location and �;idth of <br />alleys, locate proposed and all <br />� � er.isting buildings, show distances <br />to property lines, shoo: distances <br />between buildings. <br />Date Received �J � 2 �� �% � <br />Plan Check Numbe <br />Valuation �' l�!� • "C�_ <br />Permit Pce /7, �"-��� <br />Plan G�eck N'ce <br />Total I'ce Duc /7. U�J <br />Pcrmit Number ' � <br />Datc Is:;ucd_� / 7 S � <br />� �, <br />LoL• si•r.e x <br />Lot area S.F'. <br />Size oi 131dq, g,p, <br />Idumber of Sto}i •s <br />llasement_1. � � 1 � <br />Use 2one <br />�ill�►��11;���1�- <br />�....��. �.�. <br />For <br />Owner <br />LINE-I•'OR CITY USG ON <br />Firc Zone <br />Type of Construction <br />Occupancy Group <br />Occupant Load <br />Sprinkler� P.equi.red <br />APFROVED fOR QUILDING P[����IT <br />n.,�� <br />