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<br />. UI'LtdAftUN' '-(JJt "PIOOll't <br />vlty U, IRit"fIUULUJ' , <br />8utWtHU"bftltARtHItNt <br />UNHER'S _1rJ/!~'~;c// ,hill, <br />OW1t!lt'8 AbbltdS C/:?..:J' ~~JJ. fr- <br />. ' <br />; <br /> <br />JOn AbIJItM~ S /JyJ g H:S A-~t7?I?:r- <br /> <br />(Llt'( I ~i 1 <br /> <br />"'f :. <br /> <br />,I'1I0NI <br /> <br />fJt ;2;2G/ ~ <br /> <br />LBGAL bISClUl'tlUN t 1.Ot(S) bLOCK SUDblVlS10N OlYff s>'f) cT /11~ <br /> . I <br />pA!tctL t.b.' (ObtAU }'aUK paOPERTY TAX 'NOTICEl <br /> _ ~Hlt"l r!' . . " <br /> "1 <br />woRk ~RUPUSKbl____NeV tbn.ttuctloh ----...AlterAtion --Repair _Install <br />,i ____61811 --"ove --De.oliBh <br /> I <br /> . <br />I'Ropostd US!! _Sltiller_l1y --.Jf/' _' of Units ----11/11 <br /> _UOfIIII@rclal . _l..dust. _Swbl_ 1'001 _Olher <br /> <br />--Reotourant a 1I..1th~I..rt~ellt App<ovol <br />DESCRlPT1U1l UF l/UIUU L:L y:2:J pii 0 ~-r <br />BUtLblNU SIZEt IJ- Jl ~~ SqWltt! 't!et.~ 7 ~ Jlelght .1''' <br />- <br /> <br />RRStbf:NT:tAt.i;"AttAt,11 (2)1'IbT ,ws', UfSEtS 0' bUILblNQ I'LANS" (l)'SBT'ENERGY FORMS_ <br />COtlHkRdtAL I, AttAt:d 'U)fJIttS:'O' "aUtwIN(fltCANS I (1) "SR-t"ENERornFORHS." ,.". ,. <br />I 'lu'tuttr SUltVlt:IIQUllUtb:rolt"ALt Nk"'tUM!irkOOT1UNf1., , ' , ,'... <br />,',',' ,', '. '. .~,........:' ~ (":'.:'~.:~.tj}.""h,'",,,,,,,,, I . " . I "f t", " '., I ',t <br /> <br />.. t ~. I f I <br /> <br />i, ...' <br /> <br />.,,; , <br /> <br />.'! ..-,,' } <br /> <br />, /a1Ju. <br /> <br />'0-__ <br /> <br />. , <br />, ; , IERKt'tS. tuwtJlStlW' . <br /> <br />, .' <br /> <br />, ':.,." <br /> <br />_BUiLDING <br />.-JUtcrrRItAL <br />---1tEcnAlllc:AL <br />---1LUKbtNG <br /> <br />.t.S u <br /> <br />Valuatlott:tititotal ton.truction <br />,. " ~l,' ! ' , , . ~ "', 'I'lo'~l :\l:t,t!,f'.. !. ' : <br /> <br />; ~'. <br /> <br />. ! ~ , - ~ <br /> <br />, .il .. . <br /> <br />, ,,,",..,... . i <br />._AIIP Senlce "i,," rlotldA"'over lCorp. . "',i;',., . W.a.B.C. <br />I. I." . .' ,:"i' :' -.: [.i~ '\'\.,~)" .: i~';'.~Jl,.'-'~ ',-I""Oj"'~" <br /> <br />Valwatlod of' Hectuutlcal',th8tAllaUon ;~" ',. <br /> <br />r ,$, ....:. <br /> <br />'.,::,' <br /> <br />, :. I ,~.... <br /> <br />tAB <br /> <br />!RooFtNG <br /> <br />SPECIALTY <br /> <br />! ~ <br /> <br />BUILbBR <br /> <br />TIPE OF CONSTRUct!UI"'t: .,.. .Block ,,_Fru.,. _Steel <br />, .: \\ " /~ " ~~i.'h:-~, ':"1 c':!'i, (. ' :'l <br />"UUShED FJ.OOJt"'~~~~~?~I~;:;:::;~~'\,;.'>' ::.t~ '!'!tUJEet: ~~',r~D~~o1NI; ~!'~~YES' .', ~NO\" <br />: ' ..~~~~(~~.~1~'~~'~I'~~.~j~~i~~I.~~~~.'~~,'~~.~"~~.~":" '",~: ,\ :,,:"..... ~,:',:, <br />. .' \ ~_ l' . ,) . , ~ <br />,t,-: 'I' '4f '," "'tff':..."~\~n~lA'f!....,..,,, . . : .,'l,!:' :",,: It''''&h.,,,;.t '- <br />.' ,I 4 '\. ','I' ~.~. 'v t. ko~/"" <br />, ;" I.;:r\ "H.,~ ,.,' .' , <br />, , :~. .~. "'i '~ ., '~' ' \,\H~' ,.. t'f!'~ ~"(}1'!I!J."" ""'~.ff.'. <br />, ,; "J.' . ~ 'l')1,t"I'JiI:\'ifi ~f "!;~ ..A~,'. ' '..-/7,1/' /"" ~[. ' ., <br />'. : :u:..u"'&U~" u...-(9" '7'"'/ ^"", !~10"'" .,.~ <br />~l~ I,.~."'" 4,1" ~~qfr3U1111"ftnl.. ...." . . {5 r1 ~ <br />," ',~,'tl\.... \.' t.~!I ,lIIill'" .lI.."~t:ert.,.,.,t'..ltell.t~~' ::' ~~~ V~J>"b'r.t" <br />, ': '1Ji.. ;.H1,(~ 'tlt:.t*,I4i'~ ttt.ditr'.t'lhd "I' " .YOU? ?'~:'" ~. <br />....................,.......,............. <br /> <br />Other <br /> <br />, , <br /> <br />i' <br /> <br />SI81uatUt@ <br /> <br /> <br />EI.B(''IR1(;.L\fI <br /> <br />'tOtt,ANf <br />~t.te Uert. 01' Resl.t. , <br />utty Llct!ns@ Rftslstratlon , <br />....~.............~.....t.t..,.,..,...,... <br /> <br />'f, <br /> <br />SlRllatu.re <br /> <br />." <br /> <br />'r;:,~ . <br /> <br />, " . ,:" OOHPANI <br />.,8ttltetett:. ot'^k@aiRt.;'" <br />" <<1U, Llcen.e. Registration . <br />.......................................... <br /> <br />.... <br /> <br />I'LUH88lt <br /> <br />SiglUlturt! <br /> <br />t:Otll'ANY <br />, :st.t~ cert. or RegiRt. . <br />. Ully tlcenst! Aegi.traflon . <br />.............................,.......,.... <br />. <br /> <br />IlEClIAtUcAL <br /> <br />i, <br /> <br />Signature <br /> <br />- <br />\ :~, 't ~ t t J -l ,,' :'~ <br /> <br />t;UHI'ANI <br />.stAte Cert. 01' Regist. , <br />Uit, License Registration' <br />.......................................... <br /> <br />, , <br />. " .- <br /> <br />P'IIIF..R <br /> <br />" <br /> <br />....' <br /> <br />Signature <br /> <br />, !:", I ", f, 1'\ l' , <br /> <br />ArI'I.lCATION APPROVElJ BY <br /> <br />PEIUIlT OFFlCI-:R. <br />