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BUILDI:IG PRRI4IT APPLICATION <br />Applicant To Complete This Form <br />If more than one building in't'o be constructed, submit a ..^,epar.ato permit <br />application for each building. A separate Permit will be issued for each <br />building. <br />OwnerPAALESETTFIL CST. co. kx. Bu-ilding Address 160Z ilSrK. Sr. <br />Address IZ340 LNe-F- CITK W E. Lot S Block <br />City SENTT!t� Phone 3(?- 033S Subdivision (Plat) <br />Architect/Engineer CMvcle tom_ 1d/l��t<TLLY �Ln`C1 <br />CitL <br />�i, PAiLK <br />AKE FbRE6i Phone 3651396 Metes h hounds (Unpliillod) <br />, <br />Contractor ?Ace5gT --R Cam• C0•1m, Sec. Tra1. _.__ Rqc. <br />Addr__s SAM7= k% AIICIJIF <br />City ii Phone <br />Statc License Number 223-OI-44"lq <br />Expiration Date Au6 /sic <br />COIPLT:'?' PLOT PLAN ON REVERSE SIDE <br />Do Not Write <br />Date Received '1, <br />15lan Check Numbe t ZO/' <br />rrc. <br />Valuation "[` re- ' <br />Permit Fee �� /• <br />Plan Check Pec F <br />Total Fee Due _ <br />Date Issued <br />0 <br />Building Use SIP16l.$ FAMIL'If �ES. <br />Describe Work to Be Done <br />CCNSjjL0 TrorJ Or— &AJGC.R Fxwrft'1 <br />nWELLIPf6 %N5N Ccv.►Sr <br />Number of Stories 00—M W%FL%c M wT <br />Basement 1f'F_S <br />New . Addition Repair./Remodel' <br />Valuation of Construction $ <br />�28Ooo <br />Signed By MIA, <br />For -Pf c�S5'F"fYE(Z- CcxlST. Co. /,.Jc <br />)%I This Lin <br />Owner Phone362-0333 <br />-For City Use Onl <br />Use Sonc <br />Fire Zone <br />Occupancy -Group 1 <br />Type of Constructiony 1 <br />Occupant Load _ <br />Sprinklers Required <br />CITY OF EVERJT <br />APPROVED FOR BUILDING PERMIT <br />By I <br />