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(!1111' OP I:CI:rrrI' <br />1'ia;'41'I <br />I:O. <br />iSO 3._. <br />UPI'Alt'ITII:L"1' 01' CO:::.;ll1I,TY DEVIA.011NENT <br />/ <br />11U11•.1'11;U ITkIlIT APPI.1CA110:1 <br />VA1UATION <br />__-; <br />6 -f ' _ " <br />1'Ii1"21 T <br />PEE: <br />.,, <br />— — <br />ADDRESS OF CONS'TUCTION 11010: <br />U."CAL in:scurTION: L(YI' �V lt1.00R <br />PIl r <br />ekyL% <br />6/ U/mil/ <br />I':D'I.11011D) I`::!",!!'ll'Tl)':; <br />�- RUIODEL <br />ROILDING I)PSCUPTION: NEW v !DDITION dr RL'PATR <br />OCCUPANCY OR USE HEIGHTS IN STOULS <br />IS THIS A CHANGE Or DUILDI:r:C OCCUrANCY: YES <br />CONTRACTORY <br />MAILING <br />MilaSS 6 • AOX —72W7 <br />PHONE NUMBER j3E -U C) <br />NO v <br />OWNER syAiri° <br />MAILING <br />ADDItL;SS <br />PHONE MAZER <br />CONTIJ,CTOR'S LICEN.51; NUIVUD, c2v2S'01— ILA CIO <br />SIGNATURE•' <br />NOTE: VIE APPLIC,1IIT SHALL FILL IN ALL ABOVE LLAIMS CMIPIHTELY INCLUDING THE PLOT PJ AN <br />SKETCH 0;: P,EA11 01' TUIS SIIEI:T. ' TIIE APPLICIU.T IS 1t1i(:PO:\'SIRLIi rOR ALL INFOMIATION I.1111CII <br />IS FURNISHED ON TIIL APPLICATION. ANY C1LINGES IN TI,G INFOR "LMO:, PLOT PLAN OR WILDING <br />MANS SHALL liE SULMITTED TO THE, INSPECTION DIVISION FOE APPROVAL SErORL PROCEEDING <br />WITH Till" CONSTRUCTION WORK. <br />APPROI'AL: ,/ <br />PLANNING . ���� DATE 7T �i �(�Z� <br />2. ENGINE)iRI'i:G _— <br />TRAFFIC 1.11 0:1 <br />1dA'1'I?R Sl'.IN.ICE <br />SLWIiR SERVICE <br />PUHLIC SERVICE SECI'1 _ <br />3. IN SPEC'1'ION 413PARTH -NT sC�. -G <br />L` <br />G. FIRIi IIARSAIAL <br />NO'IT: A11 CONSTRUCTION Will: SHALL CONPLY IJI.111 APPL.ICAHLI. CODES, NOTES ON DRMMMS, AND <br />