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� a.i� � v� vi„��o.. � v���t�aW I!I 6!7/�'t/7v I�+:UU � :'lJL/1�.� �1�;�L� <br /> . , <br /> T��� ��: S__ D�t� �ec�ived. <br /> IEntsred �y: Perniit A�: <br /> , C�T'Y �F �It(�1�i0 - �RJY�.,DII�G PE�T .��'�.IC�#7t'�O�T <br /> � � - <br /> At� �e�Po�°mat�on �nust be su�mitted in Pull�b�foa�e pl� review �vfll be �tarted. <br /> •, (pyease priRt alt �►rformardon) <br /> � s..�.____------�------------------------�--------------._-�__o._.w__..__.�._____a-- --------___---._____-- <br /> T� ��'I:ICAIl1'T �S: (circle one) O't�T+TFR 0 N R,AC'COR <br /> ._ aroa s���a��ss: 1 S�O �o X �' . �: ���9 I +. <br /> . G�� <br /> �, ra� oF ovviv��a:�-2�t-1 c��`f`��110,� �ortE: �o��> y�-(o - 9(�3� <br /> . � (work) <br /> NIA.IL�1G A,DDRE.SS: �CI'I'Y: ZYP: <br /> CONTRA�T(��: �-�r•���,�.��,, Ardc«tN P��1�: CcSI- 2�l0�1--,��1}�-} <br /> . C+�NTA��T�R�CDN: - 1VI�BII.ElPAGEIB: <br /> � � MAII.�+iG AD►DitF.5�4: 19 a� Couni-w t�c{.C l�,�e�-!� CITY:�c�,v;�lt. ZIP:�S 1I 3 <br /> ��"Y'AT� LICEti1S�: N��];,�98� <br /> • �CI�][`I'ECT/ENiGIl�EEI�: PI$OtYE: <br /> M�ILII�G A.AlDRESS: ��7'X: ZII': - � <br /> NAMF: REGISTItA'TIUN A� <br /> 'TYIE'� Ol� '�VO]4�I�: New �dd'uion Aa;essory Stnicau� <br /> Tvlove Remodel/Alt�ratlan Land Altsration <br /> PI��POST� V,VORK(descr�be in dctai�:�.�,�aCsz y �.��Y�0 L.��� (,�1�`4-En��(1 <br /> _. ,` <br /> 5`r�lttI�S: SQ.P°�E7'GF�ACI�FL(D(�R: <br /> PdO. OF �E]D��MS: GAI�AG� S�'ALIS: ATT. I�ET. <br /> EgTIMA17E� C��e1STRUCTI��1 VAI.UA'I'IOM(excludfng laancn: $ �� �� � <br /> I ri��r�by apgly for a building p+�rmit and I ac3ccwwled�e t�t the information above is cnmp[ete a�d <br /> �cecurate; that she work wi11 be in�onforrnance with the ordinances and �odes of the City �nd with <br /> , ' the State �uildin� Code; that I uaderstand this i� not a permet and work is not ta start awlthout a <br /> pera�it; �nd that ths wo�lc will be in �ccordance with the �pprov�d pl�n <br /> �r�Y��,�rr�s st��v��• ��� �_I�OvI-�� <br /> 1V�T'E! �Hoeees �v�nts r�qufr� se�su�ate perrnit approvaC by �'mlies I)epa��bt�ent�rad <br /> City Cou�ectl b0�'ay��tor ta th�event. Alon p�rat�tted sve�ets w�lt raet b�aylowed. <br /> Rarniue,� Ti.�,,, C..., �A 1 � A�D1( D..:_ i m:__ r . _ n� � �nnir <br />