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cITY OF 1A,ERIA'T <br />DRI'AI:'IMNT OR CW,,.UNITY D1: IELOMCNT <br />BUILDING PliliMT APPLICATION <br />DATI, �0r19-1� <br />ADDRESS OF CONSTUCTION WORK <br />SU4 <br />PP.ILMIT NO. <br />VAIUATi0:1 <br />PEIU-IIT FEE <br />LEGAL DESCRIM'ION: LOT I N 10 a BLOCK PLAT 0�-0u1 o��4et¢ 20 <br />UNPLATTED DESCRIPTION: <br />BUILDING DESCRIPTION: NM _ :!DDITION <br />OCCUPANCY OR USE HEIGHTS IN STORIES <br />IS THIS A CI1A;WE OF BUILDING OCCUPANCY: 1 <br />a <br />CONTPJXTOil� o <br />MAIIAING <br />ADDRESS <br />IUii•iODEL ' <br />of REPAIR \ Do i3n 0 tumLcA,t_) <br />'ES NO X <br />OWNER 4ia, an I LO 9 <br />MAILING 0 ADDRESS <br />MIME <br />MIME 1;111MER 3.��'lJ�l 1'NOXE:NL'?!rR ang=;-0, _ <br />CONTr1CIOR'�j -,.sr In* "itrP._-- <br />NOTE: Mir APPLICA::T S:V-LL FILL III ALL ABOVII C DMET£LY II:CLUDIi G TH% PLOT PIAN <br />SIIETCii Oil RiW'S % 7Ii1S SiliMT. 'THE APPL?C:�-:T IS RrsromSLL• PO:I ALL IXFO:*VLT.'ION IMMI <br />IS FURNMIED 0:1 Tit: AP'.)I.ICI.'TIOrI. ANY Cii.•',::GCS IN T!-i. C't.TOR} 1.IC'::, PLOT PL6:: OR BLII.Du.G <br />PLANS SHALL BE SUI::IISI' D TO TIM INSPECTION DIVISIO:: FJF. APPROIJAL y P1:OCErmlic; <br />WITH TILE CONSTRUCTION lI0'.UC, r <br />n <br />APPR0VAL; <br />1. PLANNING. DATE <br />2. <br />ENGIItL'rRT NG <br />TRAFFIC DIVISION <br />WATER Sl:IiVICE <br />SrNE:: Si :tVICii _ <br />PUDLIC SEPVICE SMI'1 i:1 <br />3. INSPECTION DI:PhRTI•RiNT zL/ Gf ' , _ <br />4. FIRE MARSUAL <br />NOTE: ALL COILiTRUCTION WOIU: SDALL COMPLY WITII AI'PLICABLr CODES, NOTES ON 1)1:ANINGS, AND <br />INSl'i:C."fTU:IS • <br />