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r <br />CITY OF EVERT-,111' <br />DRPARTM;NT of CO:-WUNITY DEVP:I.0P1•IENT <br />BUILDING PElir IT APPLICATION <br />PHIMIT 140. /`6 6.3 <br />VI LUATI ON 0 �~ <br />PERMIT FEE 2 _ <br />DATE N1 cim, 7 1.q GG <br />ADDRESS OF CONSTIICTION WORK so eZ' wo v - T• _ <br />LEGAL DESCRIIPTION: LOT <br />BLOCK I <br />UNPLATTED DRSCRIPTION: 'rg- 7Ni C11�T 4L ech ef- r nF N+,vray__��_ <br />Ql "iHL' /�/.�/Z?N �,' [�!=' %UF= Nril-• 4N1-/.'. rxx OF i HF e3g= 7W <br />Mri� /Jtlwr ,_ 0/ Two, aE—,J 6f= e5 A7 Wo.C-T �!O�e7,, <br />REMODEL 7p fir, <br />BUILDING DESCRIPT10:4: NT•.W ADDITION or REPAIR x <br />OCCUPANCY OR USE eF IIEICHTS Ill STORIES <br />IS THIS A CHANCE OF BUILDING OCCUPANCY: YES NO _ <br />CONTRACTOR — OWNER r, T — <br />NAILING NAILING <br />ADDRESS ----`^--.- ADDRESS <br />PRONE HUIMi11 — 11110NE NUMBER V34 ;S ��- <br />CONTIV,C'FOR's Llclaisl( NUMBER -- __--- —_ <br />SI.CNATURI;-- <br />NOTE: Till-, APPLTC`l'T SRAT.1• PIIJ, IN A1,T. !i ili 1t7A1".S CONPLIMI.-LY 111CLUDI TlIE PLOT PLAN <br />SKE•.I'Cll 011 REAR OF THI.S 811171;7, THE APPLTGAIJ IS R"tiSPOSSII;i!i I'0't ALI, Iill'OR;;ATION WII70i <br />IS FUd,N. MIIED O`i 'fill; API'1•!CAT10i,, ANY Cll!.NCES IN THE INFORMATION', PLOT PLAN OR BUILDIEC <br />PLAINS ;;HALL LIE Sll,;}LL'i ED TO 111E TH'SPECTION DIVISION FOIL APPROVAI. DI;FO; E PLOC:I:EDING <br />WITH THE CONSTILIMT10 W010, <br />APPRO:'JL: <br />I. PL.vmmr m� K- c _ DATE�- <br />2, RNGI.NJ EKING <br />TRAVVIC DIV MONO r_ . <br />WATER SEMI Ma: <br />PUBLIC I:1:i11VICE SliCT-01 <br />3. INSPECTION Dl:l'ARTMEHT Z y 9 <br />4. FIRE M11 1AT. <br />NOTE: ALL CONSTRUCTION WORK SHALT. CO:;I'T,Y WITH APPLICABLE, CODES, NOTES OM DRAWINGS, AND <br />I.M11" ,TIONS CITY OF EVE• RL IT <br />APPROVED FPR BUILDING PERMIT <br />Dato_.P .7 -r <br />