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Ui.l':.Ia:aii:'I' Ol' CO::'PC:17:Y bIiV1:1.0!^:1:1:T <br />81111.D1.rCC 1'LIU11T APPLICATION <br />unrE <br />ADDRRSS or CONS'191CTION 1101Ut <br />PERIIIT NO. <br />VALUATION — ya a <br />111WI:'f <br />LEGAL llE,",CRI1"rION: LOT _ III,OCK mao r ,o <br />w� <br />UNPLATTED DESCRIPTION: <br />z <G <br />BUILDING 1HiSCRIr7.TON: 1111 ADDITION REr40DSr, <br />o'r numal( <br />OCCUPANGY OR USE 11EIGHTS IN STORIES <br />IS TIIIS A CHANGE Or BUILDING OCCUrAI;CY: YI:s NO C/ <br />CONTrJiCTOR o:,'NER <br />PIAlLING �-=i MILING <br />ADn1HiSS ADDRESS <br />r11011E n9 eM1311 7 7 � -'i- /r Z.EP <br />CONTRACTOR'S LICENSE Nl1IHEP, <br />I+ SIGNATURE <br />j 1N`OTO; THE AP1'LIChJ1T S1.hl.L DILL IN ALL hD01T, n]1,IiaS C0•TLCTELI' INCLUDING Tllli PLO' PLAN <br />pp ShNTCH O,y Rrlll Ol' THIS 1i11L•'ET, ;IIE APPL1C,V,T 1S REsPoxsTr.LF. rO.^, ALL INFOM1TION 1•111C11 <br />IS FURNISUL•'D ON 'TILE API-LICATIM. ANY CIL1NGr.S IILMN T11 Ii r OZ?fA't'IO:Z, PLOT PIJuI OR BUILDING <br />WITH <br />oSIICO 11E CONSTRUCTION <br />1 D . TILE INSPECTION DIVISIC:; FOR APPROVAL BEFORE r).00CEDI: 0 <br />Wl'fil TI1O• CONSTRUCTION Sv01(K, , <br />APPROVAL: 0 <br />017 <br />I. PLANNING. j 000,11 <br />2. IiNCINEERJNG <br />TRAFFIC DIVISIOia ---- Mail SEIIV.TCE ---___-.- <br />sm-1)"R SI:RVIC$ <br />PaL1C S1iRVICE SI:6PI05 - • --- <br />3. iNSl'ECTION DEPARTIniNT--- <br />• N�z6�7t� <br />, <br />k.. FrRE HARSHAL -- <br />NOTE: ALL CONS')•I(Uc7',01; l:(tla: SHALL CO::I'I,Y WITH APl!LICADLE COD1;S, NOTOS ON URAIIr.NCS, Alit)INSITCTIONS <br />