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<br /> ' " �f'. �cr.e th�n one buil3inq is to be contructed, submit a separate permit applica-
<br /> • 1:!;�n for esch buildin�). A separate permit will be issue3 for each buildinq.
<br /> ,�r • �� ("- c: ��c Huildinq Address L/'�:'�'� - �� �" �✓�` , S E
<br /> O�,mer c�:� I� /-�/��:
<br /> :�/ /.� • �. /r jAt l � ��.00�C ( �� 1� 'C �.�
<br /> Eddre�ss /c. ,.�, ,, _ _�.c.c _ __ "
<br /> ft i'C7 Sutxiirisiun tPlat) �✓ _. r !"��,:T •
<br /> . L'1Y.y � ��*�-r Phone '�-�_
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<br /> �/-'r'. .:%a. . ,�i., _��
<br /> Archit:ectJEngineer — —
<br /> � '� City Phone Me`.es fi Bounds !Unplatted) _ _
<br /> . f r Sec. �'P• R9e
<br /> � Contractor � • ,
<br /> � }lddzess • � �
<br />� �ty _ Phcne Building Use �h'�-S: a•,; ''`— ''i-:i,;: :; .
<br /> .�.
<br /> -j � Describe Wozk to Be Done 1.,�%! •�- _
<br /> , fj State License t7umber , • , :
<br /> -'t \' .,? I • .1• - ni;%.n�� l,��.s"f.
<br /> � � '. . . ::�� . � ����'�� .
<br /> i tS!piration Dat� _ .
<br /> �\ : � - SRETCH PLOT PLAt3 BF.LOi4� ' �---- - '
<br /> - • . , � �::d --r—
<br /> - .. • i . ' " ' Cse of Building /�r f'r-,, .-cv,,, h,,/� �*•i�
<br /> , 1 . ❑New � Addition ❑ xepair/Remoflel
<br /> ► . . .
<br /> ' ' ' � � . � Valuation of C�nstruction S
<br /> . . , _ . _ .,. _ `
<br /> o � � . ' . P7AT PLAN EiF,QUIR&�IENTS � .
<br /> .,....• ' � � , • � . •
<br /> � ' Indicate lot :;ize, r_ame of streets,
<br /> ' � ' � indicate locstion and width of
<br /> � . . alleys, locate ptoposed and all
<br /> exi.::ting bui.ldinqs, sho:o distances
<br /> ' 1 _ . . to prcperty lines, show distances
<br /> , 'l , ' � �° . between buildings.
<br /> y 5'
<br /> ' - - _ ypt size S 0 x �z --
<br /> . - Lot area i . .;<" _ Sq. Ft-
<br /> � • � . � Size of Hldg. ' 4�� ' Sq. Ft• 'I
<br /> • :..
<br /> - Number of Stor�.es �'�'�'- �
<br /> ' Basement ti�='�' �' '�.
<br /> : � // /� /� ['� (,t.�
<br /> �
<br /> :.• .. ' �eSigned By � iF�_ :_�,! C/! c�,
<br /> . o . �
<br /> For
<br /> . . Qwnei phone 3� ,� ,.._ '�—
<br /> � DO :70Y �i�3IT� H=i.Otl iHIS LI:]E-x'OR CITY USE Oi1L'f - -
<br /> ' � D:e Zone —
<br /> Dzte ��ceived �P-�?�.--- ,
<br /> z� -z,�� 3 Fire 2one __ �
<br /> Plan Caec:: :7iucSer ,
<br /> �� i:i �-�� `r�� Occuoancy Grou� � �
<br /> Valuation
<br /> ��rj. �._� Type of Construction �i -Nl
<br /> Pemit Fee �_ •
<br /> � �' Occupant Load
<br /> Plan Checi: Fee ��'L' � —'-- --
<br /> i�� r� Sprinklers Rrquired _ —
<br /> ' Total Fee Due �
<br /> Date Issued � � CITY Ur EVERFTT
<br /> J�ppR9`J�D FOR BUILDINC� PERMIT
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<br /> . . . �Jete�_�',. ���.—�� � .
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