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� ti <br />� <br />AFPUCATI��J Fu'ri U;�E F£V��,��IT <br />� <br />Building Permit No. <br />address ���'�'�� -`'-• i�ame of 3uildinr_ Fleors <br />�ccu anc Name � c �v � <br />�� � � <br />P Y /, ���i.:���:i,i�, ., <br />Description Idain Floor Occupancy • '�'� �• -� � <br />�J <br />Basement Uccupancy l <'h /' <br />2nd Floor Occupancy ��!!r�-+i <br />3rd Floor Occupancy -�— <br />�'ther Floor Occupancy ' � <br />� <br />�egal Description of Property ��� �-� ',J ', i ,� � ri <br />/ i ,, �. n/ � _. <br />.�.L'�i�� l.:L% �/'l�>� '�7 .c.'r . �L� �7�.�/� G,L� •i �!� •��� / / <br />'� r `f <br />Construction: (Check one) Wew __��ddition Alteration Y'� <br />Remarks: <br />Application vate �, _ Signature � � � / Phone � ,� <br />TO B[ �)IdPLETED f3Y CITY <br />Type of canstruction <br />Conformin� Building Yes_ Pdo <br />Conformin� Occupancy Ye$_ No <br />Immediate Prior Use <br />kdditional Comments <br />Floor Load Sign Issued Yes_�to <br />Iss�=d: Da{c <br />eup <br />F�rc Zcne _ <br />Capacity Sipns Yes No _ <br />ey <br />�' �. � , L � v c 1 `�1,c�'�� - <br />� <br />