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i <br />- iy90 <br />CITY Or UVIiRIiT,r PUMTT NO, <br />Dl l'AI:1'i4t:N'L' 01+ (:O:I'•!IJNITY I)EVE.LOPOLNT VALUATION 0 — <br />11UII,DI11G PERMIT APPLICATION <br />I Pl RAIT FEE 3� �-- <br />DATE. R- , - -)a _ <br />ADDRrSS Or C014STLICTION WORK "N �h 1. <br />L1iGAT. DESCRIPTION: LOT _;I BLOCK nnn 1)-0r PLAT <br />UNPI.ATTIiD DESCRIPTION: <br />BUILDING DESCRIPTION: NEW S(____.-A.DDITION <br />or REPAIR <br />OCCUPANCY OR <br />USE_ <br />ill;TGHTS <br />IN STORIES _. <br />IS THIS A CHANCE Or BUILDIYG OCCUPANCY: <br />YES, — <br />NO <br />Mai, <br />'yn <br />CONT]' :CTOR <br />_ <br />141IT,T.tIG <br />-,A <br />i•[AI7;LivG <br />ADDRESS <br />ItD1)0SS <br />) <br />—�— <br />PHONE NUMBER- <br />PHON;r liui.1j=, <br />_— — — <br />CONI'1TJ.C'fOR'S <br />LTC '.:SE NUID"I'll <br />SICPATURE <br />i <br />VOTE:TII$ /-rl'LT:C;1:'L' SiiGLI, FILL, IN AT.T, AIIOCr PJ_a:I:S C0:•IPLl;T1iLY IT:CL11DT1:G THE PLOT I .^•1`• <br />SKE,Ycil Oil Rrl,r OI' VITS Sii i1'I'. 'TIIE I.I'i'L:i.Ce`ilT IS 1 :;:PONSIDL='. re : ALL 1i; ORMI- 0 N' 1T,01Cil G <br />IS r0iiidTSlllii) G?; f111: i.PPLi:(:!')'1 ON, ful`Y CHANGES IN THE II:PO'.:' I'• <br />PLA'1.: SiTALL Bi: S:S;zI"iTTlill 'L'0 'Tlli: INSPECIION DIVISION FOR Al'i :' 1)Er0"-' PRO!:EEDING <br />WITH THE CONIS'LIWTION WO1'1:. <br />Al'PR(•'AL: <br />I. PLANNING — <br />2, ENGIN.EERIN`• _ <br />TlVwF1'TC DIVIS`J)1' <br />VAT11,1:. S1:11VIC)" _ -- <br />S1IIL'R sninTICE <br />pliBLIC 91:aVICE SECTION <br />3. INSPECTION DI:P�U2Ti•IE1P1.' -- <br />DATE <br />4. FIRE NAT:SIIAT. <br />SIIAI,I, CO:SI'I:Y WITH APTLICA71 ):„CITrYO' FOl iS1r1TS�ItIG:^., AND <br />NOTE: ALL CO::!!T1','•1CT1O1l U'011K ,�bd�b 0� D..ILDIN P IL <br />INS1'I:!:'1'IONIi <br />Date � 7 7 L By , <br />