Laserfiche WebLink
RECEIVED <br />® ~ <br />~!nv 0 7 1990 <br />-' *~ ~ U 0 L ®0 N G P E R 11/I I T <br />CODE ENFORCEMENT <br /> <br />a D <br />Jurisdiction of ~ ' <br />D <br />a <br />Applicant io comp/ete numbered spaces only. <br />Y <br />JOB ADDR ESS \^ <br />-r ~ <br />/~~ <br />~~ <br />/ <br />. <br />V Q~ <br /> <br />LEGAL <br />1 DESCR. LOT NO. <br />Iyy ~/1 <br />~~ a /~/~O BLK <br />~/[~ <br />P~~ TRACT <br />/ - / y/' / rn / (~3CE ATTACHED SN[ET) <br />C~ /r' /V Q/ [-.A/ (~F'TG <br />OWNER MAIL ADDRESS ZIP PHONE <br />z A ~ ,~4 G 2 Sp~~ i6 <br />CON TR AC 70R MAIL ADDRESS PHONE REGISTRATION NO. <br />3 <br />L ~~/l, ~ <br />' <br />AR CNITECT OR DESIGNER MAIL ADDRESS- PHONE REGISTRATION NO. <br />4 <br />ENGINEER MAIL ADDRESS PHONE REGISTRATION NO. <br />5 <br />LENDER MAIL ADDRESS BRANCH , <br />6 <br />USE Oi BUILOIN6 -- <br />7 <br />8 Class of work: ^ NEW ~ ADDITION ^ ALTERATION G REPAIR O MOVE ~ REMOVE <br />.. ~ - <br />9 Describe work: _ fir. •~~->" '~ <br />.. %r !~ e <br />•~ ~ ~ <br />sr ,~.o' <br />:4 ~ `. ~ •^ <br />ty <br />10 Valuation of work: $ <br /> PLAN CHECK FEE PERMIT FEE <br />SPECIAL CONDITIONS: <br />Type of <br />Occupancy <br /> Const. ' V Group ~ Division <br /> Size of Bldg. No. of Max. <br /> (Total) Sq. Ft. 0O Stories ~ Occ. Load <br /> Fire Use Fire Sprinklers <br />APPLICATION ACCEPTED By I'LAN5 CHECKED BY. APPROVED FOR ISSUANCE ev Zone ~/j¢ ZOne ~L / RBq Dired ~Ves ^NO <br /> No. of <br />Dwelling Units O OFFSTREET PARKING SPACES: <br />Covered Uncovered <br />NOTICE Special Approvals Required Received Not Required <br />SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- zoNING <br />ING, HEATING, VENTILATING OR AIR CONDITIONING. <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- HEALTH DEPT. <br />STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN f) FIRE DEPT. <br />MONTHS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR <br />ABANDONED FOR A PERIOD OF 6 MONTHS AT ANY TIME AFTER SOIL REPORT <br />WORK IS COMMENCED. OTHER (Speclty) <br />I HEREBY C.ERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT <br />. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT, T/iE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO Cy1VE AUTHORITY TO VIOLATE OR CANCEL THE <br />PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION <br />. <br /> <br />SIGNATURE Oi CONTRACTOR OR AU TNORIZED AGENT IOA TE) <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 />A-t <br />