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CIiY OF EVER!P;i?' <br />9UILDINa PLOT F LA?I <br />� � <br />Lot 1J�. �`� Blk. N�. Zcne ;lo. L�t�73ize �(.23x ';.,C� <br />Additi�n �� '1'�- � 4 � '� 1- '`� ; 1� I'�-c�c•�i.�{- Street <br />r t� l� � A�v c F1 RN�g 7i.. t� Avenue <br />L'nnlatte3 Description <br />� �� I i� � <br />Size of Building .��•C` x��C) -�� Hei�ht in Stories _ <br />Basement _ n,�� n/Q Occupancy i�/^�,'ti <br />Oc,mer �-f ¢o�^ ��U. •d, ,I'A�.c.�:,�, N Contracter �; Tr�c_-���'�c;t✓ <br />Date � �JZ , � �1� � Fecmit IJc. l ; ,^ i �. � <br />\�: <br />L�•� �! i <br />� i�-} u` � � <br />i � <br />� <br />i� <br />; � <br />� � <br />� ` � � � -_� <br />I,^ � � .r�su <br />I\ I cy ��i._—.1 <br />I � � <br />�J <br />� __, <br />- <br />� �`��' � <br />Remarks <br />Signature <br />F�ont <br />� <br />��t yJ <br />`� `��_� 7'`Y , . -�-�----� � <br />