2916 17TH ST 2016-01-01 MF Import

y ^ • •. . 1 � � HOILDING PESUfIT APPLICATION j j�'�`I ��`J�''`:1 � Applicant To Complete 'This Sorm '�� ' , . . �/��/ ; � .' If more than one building is to be contructed, scbmit a separate permit applica- tion for each buildinq. A separate permit will be issued for each buildinq. ' � �-- ;r';�(. ri � • • �eL � � �j � Building Address � ' � � �� ]4ddress � , � ' '=/ �r� � Lot Slock � . • City Phone Subdivision (Plat) ' ' • Architect/Engineer • ":� City Phone Metes 5 Bounds (Unplatted) ; . � � Contractor � 1 � / / ; i/, t' � � '. Sec. '1'�+p• R4e � � IidBress ��S['i�r�l�lG �)�l.l-- . � ' City �C�•', t� ,�vr /�i' Phone �( �� `��C-C� Building Use •:-�*' �� State License Ni:r.�er ��.Z 3 Uf- li'�:��!'� Describe Work to Be Done �� ,�=/�� � ' � / .. > > ,, i�.�,d ��.. ,��. �1 Eapiration Dat� �-�� / ��'- %� � l� �° ��i c c°� ��, ,�. c� �. � ,� � •� � � SKETCH PLOT PLe1N BELOS9' • I "G �/ r� �� (-�� _ , � i , • � � � Dse of Huilding � =t""_ 1 ( >L^�� L- . � �� • ❑New ❑ Addition Q`Repair/Remo�el � . .. .. . . . � • . � � ' � . ' � - Valuation of Construction $ � F��G?% �� 0 : ' � . .� i :� j .;.:. - . : .i :.. __' . '' • :70': Datc `:�ceived Plan C:uck ::u.:ber Valua:ion Pemit Fee ��'� 7 t . �— �%['��: ' '_.�- �% v v — Plan Check Fee ___ . . / /� � v , ,� Total Fee Due `�' i Datc Zssucd �1 O /�`y '� PIAT PLAN REQUI4&•L:ITS . � Zndicate lot size, name o£ streets, �indicate location and width of alleys, locate �roposed ar.d a11 existing buildings, sho�.a distances to pruperty lines, show distances between buildings. i.ot size X Lot area Sq. Ft. Size of Bldg. Sa. Ft. Number of Stories Basement i /. Signed By � % � �"-� � For Owner Phone USB U�e Zone Fire Zonc Occuoancy Grou� _ ?ype of Construction Occupant Load Sprinklers Required