�uY aax /M {� !� /� ;d„^. ,S�fi��'�V "Yy,��+�.Y'�tah SS*� M' .
<br /> ��Y�#i�.FA 5� h"A:��..:,, ' �". �rl�':��0* V�V�V .Ae . 4 Ktt� C ^A pn�� ��p4� $:�[��'ry .�.
<br /> � �
<br /> 1- Y „�s`4 hb-l�M *� '� hf r�''f �9f
<br /> `��' � '' �; T • ,.ItT F.r?T_IC�TIO:3, "
<br /> a�=�' x ���.T .D Y.Ci F..' [ a , �{�r�^�.,�,��
<br /> ^r z
<br /> �Y R$�^ k " e� ,,j �'�'a�};
<br /> / ��a ���`� � .,,.��*
<br /> Rt+11D1':G tt.kY1T hiY1Jf.�TTO!1 a�OUtRC�,T_„Vii. �� ' � `t .; ��
<br /> ���; ; �. . . .� . ,. ; ,
<br /> � i
<br /> .a,�R�qulrlr.fnts te br I�.+n1rA /n v1tA R�f1Etn�t�rwf[ Appliestten: ConurucHa��►t�ns aTostd lnctude: " b _
<br /> ��.: ' . _ � � ..: ... �. . . �. . _' Ftn[ iloov Sae�- i ....+ ���
<br /> '` .... 1)��W1lQln� trrnit Appliutfon - te be [llied out b sf�n�d . b) iootin i�foundatlaw pt+n �� �
<br /> f .� 2) }Secluntu'..fer.�it A}ytic��ton 6 C+�tenl�tton lil2ed wt _ : �j [)r�c��Y (o[dt�ilde�} ��- : �,�
<br /> s : fi��r Glevistfom -�HiteA out . � . .
<br /> '�)".,°�) ty - dj Vs1I seettons�ere�r seetion► ���...
<br /> � 4)��fnrnts�SyNc fltrorc�.L Dest�n.. . . . . s) Detaits - ststrs wd m�speel�l eonneetionx .'
<br /> } z -- ';3)��.�l�rntah� Grt4ffe�te eL Susvq . ;
<br /> ��� i) �h*nls*: sets e!Censtrvc[fon tlinr, � . `"'�",��„A"
<br /> ��.., . : . ;.. . ,:. .. . :. . �.t �
<br /> ' �)� 1 att fot Cltr te L�o a.n fflr . � . � xx
<br /> ` >:� �1)� 1-set for buflaet to uae on sfce � . . -'+a
<br /> � � . � �� � � . �� . ��� . � �V �:�
<br /> ;Y��' -T1tC��ADOVC IKYORHATIOK M15T tx SUSMITTLD EC�DAG�IUN RNTO�I�SS 0011L'�1 }�
<br /> 7� } � � .. ... . . .� . . � ��. , ..� : ' d
<br /> , ,�; � - Vork Ltyamd or vitlwut • requtted 7nspeetlert rilt �t�.subseei Se a prnattp� ,� +�
<br /> r; y,S, .. �.. . . . �: . . .. . .
<br /> �-.-� ,rr ese mr�v SI'fE "�i:rSS .3Z I.AFA�TI�--��c�� ��� �#
<br /> r:�
<br /> �ISUILDIXG ILTJ!11 � . . � �w��:
<br /> '.�l/G4a DIX�M*qw�Iq►.iD� p �
<br /> � NO.��,�DATZ � . � . i�2 - ��iocR_-,7.r--�'"avr,wu �� 4 � �.�vi
<br /> ;�-,.� �— ---- [ �-tm�,
<br /> L:.�NGO�ZT�Ki � .� W R ,� ( �me) � ., (Addnss) : � � ` tPhonel7/3'�/�/ '���.
<br /> L R I p, F��� �rta ��` ����1n c� � i�n. r a f' f� '
<br /> ,,,�..
<br /> ..��..,;•,:,F ,, x
<br /> AR�HITEC7/ENGINEER—Must Certify Multi•fsmily,Comrrrrtial b 1 ustrisi Construction%ans � ��,�
<br /> •►:s.rt � : � .. . � ��
<br /> eaT.No. ���
<br /> +:v.�o.�� •— lFirm) tAddress) ��a��
<br /> �i,��b�'�Q����'" ... :�.. ' C� I / .�.�. � n��
<br /> ,� oan�� � . .
<br /> BUILDER (Firm) G►ddras) iP►ioneF . `�
<br /> � ��:�?St4lttyCaf • . ,� . .
<br /> �f,����...•.VO!7.. t .. ,.. ... . � . ... +"
<br /> • r �a � TYPE OF WORK tw7 Addition Remodet Renovstt � � ��}
<br /> �dtl. ...lt���f . . �..,/ . � . � �,'�`j
<br /> ,,,,� � .. . .. . ... �... � . +3.
<br /> 1:CEp , � . .. . . . , °q.
<br /> �`fNr�. ./rKtwG � CONSi.TYf'E �lLDG.SIZE : � �. EST.CONST.VAWATrOM
<br /> .:cw�+ur.ov.a+c q� �c.�.� ""�'
<br /> a .; N�,G �. z w.� n,. �f .�
<br /> Y� � NESIDLNTIA �.STOfllES� 8 1 ? ./r3_� . R��t +� y;.
<br />� �l ..- �, y-. (�. .'�:�� . � �- �—� � . ` � .�.
<br /> � OWELL. J � �ORM�'f�R� ... .`� . . �.
<br /> � - UNITE / � '� �
<br /> T� GAN.STALLS SEITIC � � � -
<br /> ��+
<br /> . .,..,�E6w��E[f. �.�L� ATT. A►/OATE � . . , . � � ,
<br /> ��•.94M�wr r0't•: DET.� . ,. , t�.
<br /> 'r�t!lR.;. � OOCK � � � � `u
<br /> r ♦� r NON�fiE5�0. MOWSEOUSE ,...����. a �
<br /> :., ,
<br /> ,
<br /> � :
<br /> i�ir1' � ,.J`
<br /> ;:I1Kft[ "� ��W�•�i�'�� �. . .. . .. � �. . i�. .
<br /> . �,. OC.�.. . 1 .. . . � d �`
<br /> 1Kw�t CLA56.� =
<br /> ��, � , ETORIEf. COUMCII r
<br /> �
<br /> z'a�tlOUL�.� �I Z��� £" �IV/.DATE �� � � . ' � . ,�- ,� i
<br /> ,r�
<br /> ��y t' : �";
<br /> a �� � � � � , ,�
<br /> Nr{p�ONR01N�tQ, , wO�uc4[OlneiNG :; �SA�w�0�r�!{n��Aer�►r rtes p�liutfew lor�DvSl�in� c `"�'
<br /> (�F„r• WM�tc►ENMiif �nic ter[Mr wsk drurlNl, ��se�s [�eo�ii vork !n strfsc . t ��
<br /> �w�+ar..� `
<br /> "`^�—��ir"'�"'�iM n,•�•,� ucesl�sc�vitb �M�r1ln�nc�s et ths Gtq�E Osone�nS rutln:s�- *�j`�
<br /> ��www.r�+..w ww.�cw �l tAt ft�cr M11din�Ceds DivtNon,�Aslarrs ch�c�31
<br /> �
<br /> +..,..... .: �:� :.�« ' . . [up w� reyr�smuetews suut lur�tn�rt trr�Mt wrs�se '�_ ��;
<br /> ��.��.�WM���rrw. Nnq . . ,
<br /> �MtN�M�MrfwMl��M�� .M.ar ' . s�.
<br /> `pwY NK�M M�N IV► ��t1• w k�
<br /> y{'�qMy�t�. . .� W4YGR�Naw4.+.— � ..CCi '�: � r a��''.
<br /> `.;+wn+�•our �n»� Mts l�wcs
<br />', .:t�M1•u��rr►�..rr � � T �. ,' { ,,
<br /> ..WL�.�IYMI�I�IMI. ��M�K�4M�tur .. . " 1�. ; ,..: 2"��;'
<br /> i�
<br /> � , .: ���` �.
<br /> Y }p, \, ��.4�lA«r M�.M+.-Rn;'.N.�KcrAL•M.;�
<br /> rt;s 'w�r�.,_'
<br />
|