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MiILDING PERMIT <br />]IPPLICA':ION +"- <br />�f <br />M <br />Applicant To Complete This :-orm ��/,�,•••.� <br />If more than one building is to be contructed, submit aseparate permit• applica <br />tioa for <br />each building. A separate permit will be issued for each building. s <br />• llhrter /�/ / � , � cC .� <br />Building Address r� <br />. Pd3res <br />2 <br />Lot �4%02 Bloc), -32 J, <br />City EY_ e�._ Prone <br />_ <br />Subdivision (Plat) - <br />• hrchitect/l:ngincer <br />City Phone <br />_�_ _ <br />.Tides S Bounds (Unp].atted) <br />:,. rcntrar,Lnr � , /LFlali tc a <br />Sec. Twp. Rge) .. <br />,CityE LA±_t -1 Phone � SZ`0 � 2 <br />Building Use <br />�iState License Number <br />/ f . <br />Describe Eorl:: to Be Done wh p_�r %d•• <br />Expiration Datt���(c� <br />_`�'• <br />SfiETC11 PIAT PLAN BELOI.7' <br />Use of Building z& ' <br />a <br />nNew 0 Addition epair/Rem r. <br />Valuation of Construction 0.OD <br />-- . <br />PLOT PLAN RE UIR&%L;ITS <br />i <br />�- <br />DO NOT WRITS <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, 'locate proposed and all <br />existing buildings, show distances <br />to property lines, show distances <br />between buil.aings. <br />.Lot size x _ <br />Lot area Sq. Ft_ <br />Size of Rlcg, S7.. Ft. <br />Number of Storics <br />Basement <br />Signed By <br />For <br />Oo-:ner Phone <br />IS LINE -FOR CITY USF. ONLY <br />Date Rceeivcd 7, 2 ( 7 1 <br />Plan Chuck 27u:•ber �� <br />. .Wluatlon <br />Per -.it Fee <br />Plan check Fee <br />:bt ). Fc<` Due <br />N 7 <br />�------ <br />Me "one <br />Fire. Zone <br />Occupancy Group <br />'tpc of Construction <br />0ccn7anL Load <br />lJprin)acrs ltegnired <br />I <br />