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CI'PY OF EVE[tETi <br />RUIT,DINGFT�OTPL�.N <br />:,ot P;c. /( �// Dlk. No.� 7one No. Lot 5ize r� p x �`, <br />f.ddition _ �i"�'j..'/�,�, �?' � � � 5� Street <br />— � -- --�eitue. <br />L'nrlatted Description <br />Si2e of Building x Height in Stories � <br />&asement ���T 1 1 X .2 �/ Occupancy .,� //�/( /_ � ; �i: .: . . " ; � ,�"�,�, , <br />G�mer fs�Cr �o s�C% Contractor <br />Date ; ' Permit No, � , � � <br />. 2 II '!`I ' � E�'�f �.� <br />Remarks �l. <br />Front <br />0 <br />� i�:�i:/ r, ,i � .. <br />Sigr.ature l ���` �'/,�.LyU„( /, j C��� � <br />�YJ7:Er <br />sJ . <br />