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n � <br /> . PEIthS1T N0. �� �"� <br /> CITl OF I;VL'R�TT �Q�jy <br /> AI:PAP,Ti11iIv7` OF COi]D1UNI'PY DPV]iT,OPMENT <br /> VI�LUI�TION /C C5 `� <br /> IIUILDIIdG P1:1:?IIT APPLIC�lTIO;v p�1h�1ZT FL•'E _ - ` � <br /> DATE � i <br /> � � � I ) � <br /> ADDRESS OI' CONSTRUCTION WORK I'�� ` "' '�" "-' '� ` <br /> ��V�--l=��;i ��IU <br /> LEGAL DESCRIPTION: LOT 7 C-- ELOCK ZS � PLAT 7i `r <br /> � UNPLATTEll D�SCRIPTION . <br /> � R�rIOD�I� <br /> BUILDING DLSCRIPTION: NEW ADDITION �R REPAIR� <br /> _�— <br /> # OF UNITS �__ <br /> OCCUPi:NCY OR USE STORIES <br /> IS THIS A CF�ANGE OE� BUILDING OCCUPANCY: YES <br /> NO — <br /> /-� : � <br /> , �� 1, <br /> CONTRACTOR '�JwJ J LG' �jpILING , <br /> DSAILItiG pDDRESS C�`-� � l %�-- <br /> ADDRESS <br /> �.- ) ) <br /> PHONE NUb1B�R PAONE NUr1BER J—/� i n '�G� <br /> _�--- <br /> CONTRACTOR' S LICENSE NUDiBER� <br /> � • vc <br /> SIGNATURE L ���� —'/ � <br /> NOTE: TIiE APPLICANT SHALL FILL IN ALL ABOVE IILANRS CO.dPLETELY INCLUDING <br /> TIIE PLOT PLi;D] SKETCtI ON REAR OF THIS SIiE�T. TIIL': APPLICAN'P IS RESPONSIIILE <br /> FOR ALL It:FO?2:•L�TZ�1� �'7HICII IS I'UR27ISHED ON THE APPLICATION. ANY CHANGLS <br /> IhSPECTIONODIVISOION rORTAPPROVeO1L BEFORENPROCEEDIhGaSITHETHEBCONSTRUCTION� <br /> WORK. � <br /> APP FOVelL: <br /> D11TE _�— <br /> 1, PLANNING ._-- <br /> 2, ENGINT•.ERING <br /> TRAPFIC DIVISLOi4 <br /> P7ATER S�RVICP <br /> 5���'ER SERVIC� <br /> PUL�LIC SBRVIC� SECTION �_. <br /> � C ����-� , �' - �.-7-'1� <br /> ?. INS:`ECTIOII,DEPARTDI�P]T � - v�� � <br /> a� � � � <br /> �";�-'"---"f <br /> �. FIRE hiAR5I1lL <br /> NOTE: ALL CONSTP.UCTIOi� T�'0I:?: SIIALL COi•IPLY T•lITll APPLICAIILE CODES, t�10TES <br /> OP] DRA�9INCS, AND I?�SYIiC'PION� <br />