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s . <br /> GTY OP PVERETT PL'RI�1ZT N0. �� � -3 <br /> �i�BPAI:TD9ENT OF COMI�fUNITY DEVELOPPIT�';T ����7� <br /> BUILDING P�Rf�]:7' APPLICn7I0N VALUATION �'�_ - <br /> l�l��$ ! I�' 1�`1" PERMIT FE� 7-(�,�. <br /> DATE Y�A�t ^(:0�-- I B�..s- <br /> ADDRESS OF CONSTRUCTION WORK I� � � �t �/ '° � . � <br /> q h�-�U.� 2 � � C,p2-2a�' U' <br /> L�GAL DESCRIPTZON: LOT � 0 BLOCK 3C� 3 P�T o'.L__-W �• <br /> � <br /> UNPLATTED DESCRIPTION <br /> p n <br /> REMODEL ��Y��1 ,°� <br /> BUILDING DESCRIPTION: NELV ADDITION OR R�PAIit v� <br /> # OP UNITS OCCUPRNCY OR USE _ STOP-.lES m�'" � <br /> IS TIjIS A CIiANGE OP BUILDING OCCUPANCY: YES NO r <br /> CONTRI�CTOR �(4QA,'�., 6�1f.��h.0 01aNER ��1��� <br /> MAILING f '� MAILING ll <br /> ADDRESS p(o (}l��Cl�a2,x l�; ADLRPSS O Y� �' � <br /> �� � , <br /> PfiONE NUMIIER ��j�- -1�� I PHONE NUMBER 3rJ3 -�.��' Q <br /> CONTRACTOR'S NS NUMBER acN�^OI - � �'4'�-� I <br /> SIGNT�TURE ' `G._"�� <br /> �w ,..J <br /> NOTE: THB APPLICANT SHI�LL FILL IN ALL AIIOVE II'�1NKS COMPLETELY INCLUDING <br /> THE PLOT PLAt4 SKliTCH ON REAR OF TIIIS SIIEET. Tt3E APPLICAN'P IS RESPONSIIILE <br /> FOR ALL INFORh'1AT20N WI3ICII IS FURNISHED ON 'PIiE APPLICATION. AIdY CIIANGES <br /> IN THE IN;ORPIATION, PLOT PLAN OR IIUILDING PI�nNS SHI�LL B� SUI3MITTED TO TItE <br /> INSPECTION DIVISION I'OR I�PPROVAL IIEPORE P120C��DING WITH I�NSTRUCTIOf1 <br /> WORK. <br /> I�PPROVIIL: <br /> 1. PLANNING DATE <br /> 2. �NGINEERING <br /> TRAFPIC DIVISION ._ <br /> S�A'PER SERVICE <br /> SEWEI2 SLRVICE <br /> PUIILIC SERVICE SECTION <br /> 3. INSP�CTION DEPARTML'NT z ieh/�4� <br /> 4. PIR� MI�RS[InL <br /> NOT�: ALL CONSTRUCTION S40RK SllALL C0:4PLY �9T'PII APPLICAIIT� CODL.S , NOT�S <br /> ON DRflT9INGS, AND INSP�CTZONS <br />