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" , / <br /> rL�c,irr No. � � > � <br /> ci�r•,: or rvi-r.rrrT � �� <br /> pRP�ll?7'i•ll?:�7` 01' CO?iiiU�:T'PY D1iVIilAP;dliP]T VALUTTION ` O y <br /> I}UI.;,b7RG Pl:i5i1'P i+i'PI.TCi�'iZO:: PL1:.�iIT I°�E ��• �� <br /> � � _, 7 l�/ <br /> DI�'PB i' _' � , - <br /> `�,./i `�_i.:. .i�=i�2. <br /> ADDRESS OP CONSTRUCTIOv S'��Rh ,,��. /- <br /> '�G f� <'_,�r B]�OCK s-/'� PLAT ��_ <br /> LrGAL DESCRIPTIO:: L�T - ' '°` f' n ;— <br /> �i � .� � � �� —, <br /> UNPLATTED DlSCRIPTIOid �_- � <br /> i • I(7'ft9BE'� <br /> ADDITIO.� �_._ OR REPAIR �� <br /> BUILDZNG DL•'SCRIPTI0�1: t�E�'� -- STORIES <br /> � OL UNITS �� OCCUPi.::::1 OR USE �— � <br /> IS TSSIS A CIIANGE OF }3UILDING OCCUPANCY: YES — <br /> NO <br /> �,St- L� L-�ti� r� OS4NER <br /> CONTRACTOR r,i�ILING <br /> MAILING �--� J � ��L, AUDRESS — <br /> ADDRESS ,� U b�'� - <br /> r �1 �l � -_���- <br /> � , <br /> i; �� �- �z .r� rT' � � <br /> , ` . � . n���� PHO^lE NUt•SEER <br /> PI90NE NUhSBBR 5 `-, } ` 4 ._ <br /> �� .,, �/ � L� <br /> FR <� L � c � i <br /> CONTRACTOR' S LICENS�IN D� <br /> I?'�, ,.���._ <br /> u IGIdATURE <br /> NOTL•': THE nPPLICANT Si1APL FIL���ISLI't rI�OVE T iEt`APPL�ICnL't'TZSYRESPOt�SISLE <br /> TIiL PLOT PLF::: S:;i:�Cil 0.. �'+R 0. <br /> FOIi I�LL I��l�'-�=+^ii�" PLOTIiPLAi�£OR 'IIUILDIOG PLEt�SPSHALLTIIEI,SUII tITTCD`,lO�T:�� <br /> IN TfIE INiORi•;AiIO:v, <br /> TRUCTION <br /> INSPtiCTION DIVISIO:v' POR IPPROVAL IIEFOP.E PROCE�DIi�G �9ITfl TIIE C <br /> WOI2K. � ✓ <br /> I�PPFOVAL: ` <br /> DI�TE ____�----- <br /> 1, pLANNING <br /> 2. ENGINE�RING _ <br /> TRhF"Y'IC DIV] :;10i4 <br /> 47A7`i',P. SERVICIi <br /> SE�•�I3R SERV7C� �_� <br /> PUI3LIC SERVICG SECTIOi7 �_ <br /> ?, INSPECTION DEPt'�RTb1TyT <br /> ------ <br /> h. FIRE i•;Al'SIIi�L p;U,r:'.:� <br /> �nii:: AT,L CO:;ST�i:CC'��7G�: 1:OR?: 5;:'•.:�L LO'�iPl,'I S7ZTIi TtPPLICAIII�I: CODES � <br /> Oid I)RL�tiI:iCS� i�'4D Ii::Si'iiC'P10:CS <br />