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1 BDILDING PIM,41T APPLICATION / !"•, �j <br />•• Applicant To Complete This Form <br />It pore than one building is to be contructed, submit a separate permit applica- <br />tion for each building. A separate permit wi 1 be issued for each building. <br />Ovner <br />rI ®u�7flinq Address <br />, �f / ��Lli{iL�fi. <br />dddress 7 �n S / Lot Block <br />city F1 or ,tI Phone,3S�i ' .SS Subdivision (Plat) <br />' llrehitect/Engineer <br />• : '.i <br />city Phone <br />Contractor-_c2<o- Li e <br />-' ; • <br />!.;cress _ <br />Y. <br />-City Phone <br />State License <br />: ( <br />Expiration Date <br />SK-TCH PLOT PL7iI BELOW* <br />L. <br />Metes L rBounds (Unplatted) <br />Sec. a TGp.2 5' Rge <br />13uilding Use .. -!,; <br />Describe Work to Be Done <br />Use of. 3uilding _ <br />*New ❑ Addition ❑ Repair/Remo`cl <br />Valuation of construction S 500 <br />:,PLOT PLAN =-QUIRE.'•1 :ITS ;. <br />°.`+• <br />.Indicatr.. lot size, name of streets, <br />•inclicate location and width a' - <br />alloys, 'locate proposed and all <br />existing buildi:gs, show distances <br />-io property lines, show distances <br />_,botween buildings. <br />,. <br />'Sot size x <br />Lot area Sa,: Ft. <br />Size of Bldg. Sc. Ft. <br />Number of stories <br />Basement _ <br />SignedBy � <br />' For <br />Owner -Phon <br />DO NOT WRIT? Br -LOW THIS LINE -FOR CITY USE ONLY <br />Pate Received S -7 Use•Zone <br />Plan Chcc`. ]Iu .bar _ Fire Zone <br />valuation �[TJ!`J- occupancy Group <br />Pecnil•' Fee _��1 Type of Construction <br />Flan Check Fee l Occupant hood <br />Ybtal Fee Due �c,-�/7�,—� Sprinklers Requ).red _ <br />Pate Issued <br />