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1 " . . ' /� %t �: <br />� <br />y BOZLDING PFRMIT APPLICATION .'�f I/.'J .� <br />,' • t � ,1lpplicant To Complete This =orm ' <br />• . 5��/,�'%. <br />, •' If more than one building is to be contructed, submit a separate permit applica- <br />. tion for each buildinq. A separate permit will be issued for each building. <br />"' os+a=r l/ I oL�-- I`�� .T�c�Y-�.��suildinq nddress � Z�Q-�T(-� <br />, <br />' , Eddress ��p¢ �T�-� Lot Block ' <br />City Phone Subdivision (Plat) • <br />' hschitect/Engineer _ � <br />`':� City Phone Metes & Sounds (Unplatted) <br />, .. <br />. , Contractor ' Sec._ �rp. Rge <br />. . .� . <br />` llddress � � <br />� �. <br />! City Phone Buiiding Use �( p��9 G�- '"'.': ;�^',. . <br />� �'t'� � State. License Number � � Describe Work to Be Done .� '� �. <br />� � .I Ezpiration Dat� ��hi�'�.���'1- C-�1—l1S.CaS <br />�� ' � � � SKETCH PLOT PI.AI� IIEL014 � ' <br />� . - ; � ... . ' . ' . . .. � .. . <br />� Dse of Building <br />1 <br />� � .' ,:. �New L� Addition CA-Ytepair/RemoGel <br />. . , c .. , ; . . � � ' � S�d• .�: <br />' � : . . . 'Valuatiou of Construction $ <br />^„- • � ' . . .. . " � . . PIAT PLAN REQUIRF.AIENTS . . <br />� • � . ' • , • Zndicate lot size, nane of streets, <br />� i • ' indicate location and width of <br />, � " =. .- alleys, locate or000sed and all � <br />, :•�j � � .� � ' : , - . I . � Existing buildi.^.gs, show distances <br />� � •-�o t� property lines, show distznces <br />„ <br />• a • between buildings. <br />` s <br />r.. - <br /><; <br />. : . <br />:.. • <br />.�. —' <br />. i. <br />Date ?:�ceived <br />Lot size x <br />Lot area Sq. Ft. <br />Size of Bldg. Sq. Ft. <br />Humber of Stories <br />Basement <br />-Signed By <br />For '�i � cro� i"� �,P1YP _ PO_ <br />Owner one <br />B'c:,0[7 THIS L7:1E-cOR � <br />Plan. Check :7ur.,ber ' ' <br />Valuation SZi` O � ��` <br />Pemit Fee � � ��'"' <br />Plan Check Fee <br />' � OC <br />� Total Fee Due <br />. � / <br />Date issued S C� 7 <br />a <br />D=e Zone <br />Fire Zonc <br />'L <br />Occunancy Grou� <br />Type of Construction _ <br />Occupant Load <br />Sprinklers Required _ <br />