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_. � <br />- :� • BUILDING PERt4IT APPLICATION ' . <br />• -1�pplicant To Complete This :prm � �' <br />• I! more than one buildinq is to be /�-J~�/ �.,�t <br />• tion for each buildin contructed, submit a separate `�/�� <br />�• 11,separate permit will be issued for eacheb it appllc ��� I <br />. Ower < 7 <br />1 ' <br />, : <br />.:.I <br />_ _ _f <br />; , <br />, <br />`� <br />. . si <br />; ' �( <br />�1 : <br />..'1 . <br />::� <br />� . <br />; <br />e <br />,..., . , <br />, „ � � uz ding. <br />� o' Buildinq Address � / <br />2ddres � .��tF � �/,s- � af, � ��Z�� =-� <br />-- -- � � Lot '�� � glock � ; <br />City L-i,- Phone �i �y- '-/J- a o <br />�� �`/Z Su6division (P�3t) �,� , <br />Erchitect/Engineer - • c : <br />City � ��l� �t :d / "� ��� �- <br />��Phone Netes s Bounds (Unplatted) <br />Coattactor / --- <br />n �_ <br />�ddress ,S � / ) ��, � .� .( <br />City t�Z'--�__ Phone �,S_ 1-= � Z <br />State License Nu,�aber �„� ;-v/ - �a' �S <br />Ezpiration Date <br />• SKETCfi PLOT PLp,p B£LOf9 <br />/ ' i" i��c� �. <br />:� <br />St:i <br />Date ��ceived <br />Plan C:�ec;; y�,_,5�: <br />Valua:ion <br />Femit' Fee <br />Plan Check Fee <br />Total Fee Due <br />Date Issued <br />r <br />Sec. �— <br />— �• Rge <br />—�� <br />Building Use _ • <br />..;^ !. <br />Describe Work to ge Done ' <br />' ,� _.; , ... <br />� _. _G'=wc�C7�/''� , ��_ <br />� -'�i-�-1 -� --`, / • <br />Ose of Buildiny _ ����� , <br />❑New ❑ Addition <br />• 0-Repair/Remo�el <br />Valuation of Construction $----�p��r iv � : <br />. PIqT PLAN gEQUIRE�I�NTS <br />Indicate lot size, nane of streets, <br />indicate loca:ion azd Wi��h o� <br />allcys, locate nro�osed and all <br />existing buildinqs, sho:a distances <br />to property lines, show distances <br />between buildings. <br />Lot size _ x <br />I.C1t dlea <br />Size of Bldg, Sq• Ft. <br />Namber c' Stories�— SQ• Ft. <br />Basement , ---�,. <br />Signed By � �✓� � ' . <br />_ . / �C/� ;/G� � � ,, <br />For <br />�wncr Phone <br />LI:dE-POR CITY USE OiIL'! <br />Uce Zone <br />. �_ <br />Fire Zonc <br />�_ <br />Occuoalcy Grou� <br />TYpc of Construction <br />Occupant Load <br />Sprinklers Required <br />