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�""""_"� <br />. i <br />._ � <br />� <br />DOZLDTNG PERM:. LICflTION <br />�pplicartt To Com. _te This :orm <br />If moze than one 6uilding is to be cc tructed, submit a separate permit applica- <br />tion iot each buildinq. A separatP_Farmit will be issued for each building. <br />� � 4 /�`�' ��- 'l/. • <br />Ovner ,��,� f ;- �,C�F� �i -�'1, �%'. _i,i-�'-� ' ' Buildin Address � j : <br />�ddrees �'`�G `- � , . �' ��� •' ` , <br />�� �� �"`� 7 _>iiii� ' : l . Lot B1ocTc — <br />CiCy /`/<'-'��i'.<�%1� Phone/ % ? _-.'Cj 1 Subdivision (Plat) � -• �� <br />�rchitect/Engineer _ �_ <br />•°•+ `"� City . Phone Metes L Bounds (Unplatted) <br />- - "i — <br />:,' Crmtractoz ��/�11i� l:r:n �;7=� %%Jli/!=J Sec. 7.Wp. Rge . <br />c �J,+ �- • . <br />2ddress � �'' � - � • <br />� <br />� ' City %,. 'r JPhane /i'% i'1�J� Building IIse .i.,/ �c �'� i/�� .'�>'. <br />� rj State. License Number r' �"' ;' �' �,x<.1�'�'!y � Describe Work to Be Oone `� •. �'�7l1 ^' . <br />, . - � ' <br />� � �i P•ipiration Dat� � � ' ` '� �i; l/�'%-�' �= -:� ��• � <br />-�' �� � SRETCH PLOT PLAI7 BELOW' • .- <br />. <br />i <br />� <br />•i.' ::il <br />; <br />• ,,�Ilr .)�1�(. . <br />�{ ' � <br />C . i` . <br />.'i� �..#{'.r <br />• I: :j: <br />., ' <br />�>:• — <br />�✓ . /J�'�-!�- _ <br />i. '�� <br />., y_. _ . <br />�= <br />� Da� of Building c�",c'-=iir >''i i��� <br />�]New ❑ Addition Q Repair/P.amo6el <br />v ._ <br />� Valnation of Constructioa $ .',-�i �-� �0 <br />. . YYAT PLAN REQUIRE?1ENTS � . <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate nr000sed and all <br />existing buildings, sho:a distances <br />to property lines, show distances <br />betveen buildings. <br />S.ot size x <br />Lot area Sq. Ft. <br />Size of Hldg. � Sq. Ft. <br />Number of Staries <br />Basement - <br />Signed Sy �� <br />Fot - ;: .i�; "/ y' �. �r:� � [� <br />. .. �, . <br />� Owner � Phone ; iG' . ��.!".'.. <br />- DO NOT {i:iITS B'cLCC4 THIS LINE-POR CITY USn O.ILY <br />Date r�ceived Ace Zon� <br />Plan Check :Iur..ber <br />Valuation <br />Pemit Fee <br />Plan Check Fee _ <br />Ybtal Fee Due <br />Datn issued <br />Fire Zone <br />Occuoancy Grou� ,z,.��� <br />Type of Construction � � r7 `�'� I !� <br />' U .. ..� : � • � <br />Occupant Load �,� �y �) �i jQ7R__ <br />Sprinklers Required � - ��. <br />� � ^ ^ ' <br />. , . . �RSPeCii�ti �;e�t; <br />