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BUILDING PERMIT APPLICATION <br />Applicant To Complete This corm <br />If more than one building is to be contructed, submit a separate per;nit applica- <br />tion for each building. A separate permit will be issued for each building. <br />Owner Building Addresv ;.�� % . <br />Address Lot '' Block <br />City Phone Subdivision (Plat) 14P/'! 'ic k_, <br />Architect/Engineer <br />City Phone Metes 6 Bounds (Unplatted) <br />r' <br />Contractor i i Sec. <br />Address <br />City Phone '� �lC%i i/ ) Building Use <br />Twp. Age <br />State License Number f�{'+t� escri be Work to Be Done ' <br />Expiration Date A, - i 7< r �1 �,, O <br />SKETCH PLOT PLAN BELOW <br />Use of Building <br />❑ New ❑ Addition `d Repair/Remodel <br />Valuation of Construction $ <br />PLOT PLAN REQUIREMENTS <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate proposed and all <br />existing buildings,.sho%v distances <br />to property lines, show distances <br />between huildings. <br />Lot size <br />Lot area Sq. Ft. <br />Size of Bldg. Sq. Ft. <br />Number of Stolz s <br />Basement <br />Signed By <br />For <br />Owner Phone <br />DO NOT WRITE BELOW THIS LINE -FOR CITY USE ONLY <br />Date 9eceived <br />Plan check Number <br />Valuation <br />Permit Fee <br />Plan Check Fee _ <br />Total Fe: Due <br />Date Issued <br />ULe Zone <br />Fire Zone <br />Occupancy Group <br />Type of Construction <br />Occupant Load <br />Spr}nklers Required <br />CITY OF FVFRFTT <br />APPROVI D I'0R Ci!!.'_;:! r.'RA11T <br />3 <br />i, f , /o -/. 3 ::f a <br />