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BUILDING PERHIT APPLICATION <br />Applicant To Complete This :orm .-• r - /"7i ' <br />+ If more than one building is to be contructed, submit a se arate / tion for each building. A separate permit will be issued for eachebuildinplica- <br />11 <br />g _ <br />• � • Ownet ��r2 i' r �1 C ' c • ems' Building Address � i � i• ., ;<, •` �% <br />. Address 5 1{, 1 ` ;/ Lot _ <br />Block _ <br />city Phone SS 3 •(- ! subdivision (Plat) . •C.''r.� i • e <br />Architect/Engineer <br />city Phone Metes c Bounds (Unplatted) <br />Contractor ;�i l%�''2'�� <br />• sec. Top. Rge <br />i. <br />- Address <br />}} City Phone j .l S Building Use <br />Strte License Number ? 5 C` Describe Work to Be Done �� C i % •� ' . <br />,t Ezpiration Data / �• <br />•w\y SICETCN PLOT PLAN BELOW • <br />•' - _ - <br />IIse of Building + <br />+ ONew O Addition <br />®"kepair/Remodel <br />• • j Valuation of Construction <br />e .. PLAT PLAN REQUIREMENTS . <br />• Zndicate lot size, name of streets <br />,.( 'Indicate location and width of <br />;• % alleys, locate proposed and all <br />y: y existing buildings, show distances <br />to property lines, show distances <br />+.i between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />.• r' B <br />Size of <br />f g• Sq. Ft. <br />• - blumber of Stories <br />r.. i Basem nt <br />• Signed By\Y: <br />1 <br />For <br />Date Received <br />P1an.Check :lumber <br />Valuation �Q-C <br />Pewit Fee <br />'Plan Check Fee <br />Total Fee Due �JZ •Q <br />Date Issued S� <br />Owner Phone <br />USE <br />Me zone <br />Fire zone <br />Occupancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />