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ITY DIiVIiLoPPlENT , <br />'i!JILDI.NG ILL iri., ....iICATIO;I <br />PERMIT No. 1z2611 <br />VALUAT'IO.; ' 9&4F�� 0 <br />DATE <br />ADDR1iSS OF CONSTUCTION <br />LEGAL DESCRIPTION: LOT <br />UNPLATTED DESCRIPTION; --- <br />l <br />BUILDING DESCRIPTION: NEW �_ DDITION <br />( OCCUPANCY OR USE fAst Ic/'no0 HEICH•TS I71 STORIES <br />IS THIS A CHANGE OF BUILDING OCCUPANCY: YES <br />CONTRACTOR{51DNE[NGrtNEE.�IAl6- <br />11AILING <br />ADDRESS 1�� VJ. <br />PHONE NUPUSER T� <br />CONTRACTOR'S LICENSE?iUILER <br />SIGAZATURE <br />REMODEL <br />Or REPAIR <br />I sTya <br />NO <br />01-NER <br />HAILING � <br />ADDRESS ' <br />PHONE •NUMBERF" 7At1 <br />NOTE: THE APPLICA11T SHALL FILL IN ALL ADOVfi BLANKS CO'. ?LF.TEI:' INCLUDING THE PLOT PIAN <br />SYETCH 0.1 REAR OF THIS SHEET. 'THE APPLIC,tNT IS Ri,sraCSIBLE POR ALL INFOrj-ViTIoi1 WHICH <br />IS FURNISHED ON THE A?PL•ICATION. ANY C1ANGOES IN Tli'� INTORMzw.'ON, PLOT PL41 OR EUILDING <br />PLANS SILALL BE SUEMI10ED TO TILL INSPECTION DIVISIO•;: FOR APPROVAL BEFOP. P H=ING <br />WITH Till -,CONSTRUCTION WORK. / <br />APPROVAL: <br />1. P1ANNING• DATE Cl` <br />2. ENGINEERING s` 6 <br />TRAFFIC DIAZT01N7.1 <br />WATER SERVICE = U <br />SEWER Sia;VICE 3 <br />PUBLIC SERVICE SECTI :i <br />3. INSPECTION DEPARTMENT %(�- <br />4. FIRIi 1•IARSIiAT, <br />NOTE: ALL CONSTRUCTION WOP,1C SHALL C0:•11?1,Y 111TH APPLICABLE COD}iS, NOTES ON DIZAIIINCS, AND <br />INSPEC'TIOPS <br />.. 1'��. .x�at;�:..+.y........i�... � - .,_un;n..:..at.,:. _ - - -^�_•xww.::e+.nn..+'.,•.w:-..::..+.od—_.�.�,.. <br />'1 <br />_.._+zap- _r=: •- .r .. <br />