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A.: , <br />RECEIVED <br />BIJILDING/~PERMIT MAY 251989 ; <br />O <br />Jurisdiction of_ ~.GZ /-O~~e- rnn` ~Og~~M~ <br />D <br />Applicant to complete numbered spaces on/y. <br />Y <br />cos woDR css // // /~ <br />~ 7~ C/~ bl?,rr /~ VPa'J ~/C' ~CLf ~'rc % - Gaffe -,So c <br />LOT NO SLR TRAL7 .. .. <br /> ILGAL <br />1 D[aCR. ~ (00[[ ATTALN[D aN[[TI <br /> 0T4N[R <br />z Ii <br />~// <br />~ MAIL ADOR[ef "' IIP NONE <br />~ebs~v <br />• S~~G -/ ~ ~ 9 <br />~ 6~/ <br />5/~3 ~/d <br />t l~ <br />•~ <br />~ <br /> a r~- <br />i• <br />i ~ <br />On rtQ <br />~ri~ er <br />e~ .: <br /> CONTRACTOR <br />3 //ll MAIL ADDR[Sf "" <br />t <br />2 - PNONC <br />/ e <br />~ •REGISTRATIONNO. <br /> ~ di-YI U0~7i7 Gt I,A r / S~ . <br />o <br /> wltcNlTCLT OR OCSIGNLR <br />a MAIL ADDRESS <br />~ 7a G . iPi~-ey PNDNC ~ <br />30 3 <br />573- 3 REGISTRATION NO. <br /> . <br /> [NGIN[LR - - MAIL AoDRCSS - PNDNL REGISTRATION NO. <br />5 -- <br />LLNO[R -- ~ ~ MAIL ADDRCSS - •' - DRANCM " <br />s ~~s f Ci~ ~l ~ ~ ~'>`o. ~//o( ,~i„~t dS ~ err ~'+~2 <br />vsL or evILDINa .. ._.. .. <br />7 ,Sid /e ~u~ // rPLI~" c e. <br />8 Class of work: ~ NEW ^ ADDITION ^ ALTERATION G REPAIR D MOVE ~ REMOVE <br />9 Describe work: ~~ ~ J ~•~• <br />10 Valuation of work• S 8O D ~ <br />' ~ QO' PLAN CHECK FEE PERMIT FEE <br />SPECIAL CONDITIONS: Type o1 Occupancy <br />C /,H'I.. f L• P-c.1 d Y r ~ 6 Const. Group Division <br />d G G~ ~ { t L /1/ <br />G ~ ~~ Si2e 01 Bldg. NO. 01 Max. <br />/ <br />~eM r~/ /~~ .C, (Total) Sq. Ft. Stories Occ. Losd <br />5'/ ~e Z Fire Use ~ Fire SDrinklers <br />APPl1~AT NACCE PIED BV WEANS CwE KF APPq E FO ISS IANCE ~ Zone Zone ~ Required ~Ves ^NO <br /> <br />' ;~` <br />_~."~ !• ' <br />'• _ <br />NO. O1 <br />Dwelling Units <br />OFFSTREET PARKING SPACES: <br />Covered Uncovered <br />NOTICE ' •• Special Approvals Required Received Not Required <br />SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- zorvlNG <br />ING, HEATING, VENTILATING OR AIR CONDITIONING. <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON• HEALTH DEPT. <br /> <br />STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN s - <br />FIRE DEPT. <br />MONTHS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR <br />THS AT ANY TIME AFTER <br />FO <br />PER <br />M SOIL REPORT <br />R A <br />ABANDONED <br />IOD OF 6 <br />ON <br />WORK IS COMMENCED. ., OTHER (Spec)+y) <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APP <br />E TRUE AN <br />RRECT <br />T <br />. <br />LICATION AND KNOW THE SAME <br />O B <br />D CO <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />P <br />ITH WHETHER SPECIFIED <br />T <br />P <br />' <br />Y <br />E OF Y. <br />ORK WILL BE COM <br />LIED W <br />HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT <br />PR <br />I <br />ATE OR CANCEL THE <br />T <br />T <br />T <br />HORI <br />O V <br />ESUME TO GIVE AU <br />Y <br />OL <br />PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTR <br />R THE <br />RF <br />RMANCE OF CONSTRUCTION <br />T <br />. <br />ION O <br />UC <br />E <br />O <br />~ ~ A <br />31 r CON TR AC TO R AU NORI2 LD AL[N7 ~ IDAT I <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH <br />EXHIBIT' .~ <br />A•1 <br />