Laserfiche WebLink
CITY OF hVI:RI:I'7• <br />DEPARTMEIN1. OF CON.AINT•lY MIXG1OMMENT <br />DULLDINGITMIT APPLICATJON <br />76 <br />ADDRESS OF CONS'1'UCTION WORK /�OC <br />MCAL DESCRIPTION: LOT - /: BLOCK <br />UNPLATM) I)PSCRIPTION: <br />BUILDING DMIcitiPTION: }E1J s.DDITION <br /># of UNITS 6 I , t ,' z "-- <br />PEIUIIT NO. <br />a <br />VALUATION <br />PF)MIT Plili //n tin <br />rl AT <br />o'r <br />OCCUPANCY OR USE,10W 11L••ICHTS "I STORIES l/ C <br />IS TIIIS A CHANCE OF DUIIMNG OCCUPANCY: YES NO//JJ <br />CONTRACTOR 961 _ (MINER //�) e. �1� %... , • <br />MAILING ?fA ILIRG� <br />nvvrosss ADDIIESs <br />PIICUS A'UMER PHONE NUZIMER s��j�-�— 5�� s��• , <br />CONTRACTOR'S LICENSE 14M.f IM <br />SIGNATURE <br />lQ <br />NOTR: THE APPLICANT SLALL FILL IN ALL ABOVE mixaS C0:•R'J.rTET.Y INCLUDING THE PLC.' PLAX <br />SKETCH ON %1' OF THIS SHEET, THE APPLICANT IS RESIONSIBLE 1'0R <br />T ALL INFOW-1ATION V NICH <br />14 FURNISHED OR TILE API LIC4TIOii. ANY CIIAP.GrS IN TI(T INTOn?IATION, PI,(Vf I'Mil OR BUILDING <br />PLNIS SHALL BE SUEMITT11) TO THE INSPECTION DIVISION FOR APPROV.IL DEFO ItOCEEDIi,G <br />IJI'TH TIIR CONSTRUCTION 1,OItK, <br />APPROVAL: o^ <br />1. PLANNING. DATE <br />2. ENGINEERING <br />TRAFFIC DIVISION <br />WATER SrRVICE <br />SM-mit s),RVICE _ <br />PUBLIC SERVICE SI:C'TION <br />3. INSPECTION DEPARTDiNT <br />G.. PIKE NARSUAL <br />NOTE: ALL CONST•RUCT•ION WORK SIIALL COAPLY WITH APPL1=11,11 CODES, NOTES ON DRAVINCS, AND <br />INS1'IiGTIGNS <br />