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_ . _-..�.__: . <br />AUILDING P1;RF:IT nPP:LICATION <br />npplicant To Com��l.eLc 7'hi.s. Porm <br />Ii mo:e ti�an one bui].ding is� to becconsL-ruc je��lliLu�+��ll <br />acli building. 7+ �cparat�e 1 <br />appli.�ation for c <br />builuinq. / <br />O�mer �n,cJA%d L� � '-� <br />-� S <br />Isddress � i ln a ( �' �. <br />City � P :z � .jf- Phone ��J� <br />Archi�cci:/�ngineer _��— <br />City Yhone <br />Cont*actor fOc� J ¢ �'-�� ti'� ��' ��. �G . <br />Addr�_�s �� �v ;u �,.,.� <br />¢( �� ,J• l,� - 1/Z Sk� <br />City �-- yll� Phone 77 �.1 i G% <br />State License 13umber J 2�� ����� <br />Er.pirz�ion Date <br />CO]�PT�_== P7.OT PLA2J Qi+ Ii�VEI;. E SID� <br />< i'%—%�'� <br />., <br />, ' / ,� �/;. , . <br />a separ.at-e per.mi.L•�: <br />be is�ucd for. c,1ch <br />nuilain9 naai��� <br />Loc / � // rsiocr, iJ /� <br />Subdivision (P1aL•) �Qd_.— <br />Metes &' IIow�ds (UnplatLc:d) <br />Sec. Twp• Rgr• <br />Buildin9 Usc � C� C <br />Describe (•7or}: to Be Done �_ <br />� .�r„ <br />l! :;.— ' ` �� ,� ��:%, t, `/�"' ' ` <br />Number of Stories <br />Basement <br />lsew Addition Repa�r./Remoclel� <br />�K% <br />Valuation of Constructio � ��6 - <br />s�Y �, <> f-�G <br />-�. <br />Signed�� � r_.�e:r� <br />. For ��t.. � ��--' � ------- <br />Owner -`"'1p1e' 7� � <br />. ' • ' Use Only <br />� '. Do 1'ot �•7ritc llelow Thi� r,inc-ror City <br />_ ... . , .' Use Sone ' <br />Date Received F�r�, 2one <br />IS].an Ciec): NumUer <br />Valu=_tion <br />Pernit I'ee __ <br />Plan Check ree <br />Totial 1'ee DllC _ <br />patc Issued ,� <br />Occupancy•Group ,_. <br />Type oi Consi:itic�ion <br />Occupant Load <br />Sprinlcicr.s Rcc�uired <br />6 <br />