25-076 (3) �'
f
Crt
i
C\�
� � V
��
v �
IIV
r10 � a
m w f ° at
sr + d
Ej u "
z
LL
a % 3
j2
��r-A
90 I
Co
do
� I
i
� I
" f
k I
t f
:so —
i
Z
;..�
��
_ : - �
i
Zo
Cit
y or mortbamun BUILDING —a
0�
ERM IT
VALIDATION
c-
DATE 19 PERMIT NO.
APPLICANT ADDRESS
IN 0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) DISTRICT—
(NO.) (STREET)
rn BETWEEN AND
�o (CROSS STREET) (CROSS STREET)
01
LOT
a SUBDIVISION LOT BLOCK SIZE
m
u BUILDING IS TO BE FT. WIDE BY - FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION - --
� (TYPE)
K
O
LL REMARKS:
AREA OR PERMIT
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER BUILDING DEPT.
BY
ADDRESS