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SUILDING PERMIT APPLICATION <br />1 ?orm <br />applicant To Complete This te ermit applica- <br />submit a separa <br />- is to be contracted, each building - <br />If more than onbuilding. <br />building,, Separate permit will be issued for <br />flop for each ) Building Address <br />owner t Z Block S� <br />address gubdI ision (Plat) f <br />Phone 1r <br />' city ,�=�:-�- - <br />azehitect/Engineer Metes a Bounds (UnPlatted) <br />Phone TwpRge �— <br />city---�"- gee._' — ; <br />/LUr <br />contractor / . <br />address % {� Building Use <br />K r-� l' Phone �— <br />i City o� Describe Work to Be Done �-- <br />er e i <br />State License Numb n U � C � <br />+i J <br />1 ` �/ p•LW 1NK I d I C/A <br />•. .•.1 yzpization Date , <br />• ETCH PLOT PLAN BEL014 . <br />�. Use of Building Remoriel <br />i Addition 3Tepair/ <br />[]New <br />Valuation of Construction $------ <br />• t PLOT PLAN REQUIREMENTS <br />Indicate lot size, name of streets, <br />• aof <br />indicate locatioosedland all <br />t alleys, locate pro' <br />show distances <br />i existing buildings • <br />to property lines, show distances <br />between buildings. <br />Lot size <br />Sq. Ft <br />Lot area Sq. Ft. <br />Size of Bldg • �— <br />Number of Stories <br />Basement <br />i Signed By <br />+�•_ For Owner Phone �---� <br />Date Received _ <br />Plan Check :iurber <br />valuation <br />pe=it Fee <br />plan Check Fee <br />Total Fee Due <br />Date Issued <br />Ute zone ------- <br />Fire zone <br />Occupancy Group <br />Type of Construction <br />occupant Load <br />Sprinklers Required <br />