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1018 PUGET LN.pdf, r ( )! r.•.w.yr.r4w1 r.r4. ..r.•+ ...r �.•r{ L{ 111 F!, `• t }�F 311 O l��a tt pi+r VIA 7 APPLIGATION is hereby made for a permit to construct the following work, in accordance with 'the accom panying plans and specifications. Two seta are submitted herewith for approval. } ' new alter �� Off -St Work addn repair .................................................. ..... .......... ................. ....... Parking• .-..: Occupancy.......... Const. type :.... ......... .......Use zone::. :. Fire zone ......................... ! Address ............ %Q /....✓.:.?`�G- •....�..-...... Blk .. Addn....... Lot frontage .................. Area ..-.. Septic tank ........: ......... .... s Bldg. setrbacks -front ....:.::.......-...... r. side ............ ..........: 1. aide ................:. rear................................ Owner.. ,./ .... ............... Address.-...... ..-................. Tel. No.- .................. Build(.rt .�r�r' t� ... c- Address: fir -ems o �/.. �p � .i er. Tel. No . ..............���; .per_ � • Plans by ......................................................... Address-..-•... ....-................................. Tel. 'No ...................... . Re -marks ..................................................................................................................................... ...... ....................... .. -1 The above is a correct statement, and I agree to comply with all applicable Codes and State ° laws regulating this " work Signed Owner/Agent....... k .. "'.............. Address.......... ........... ... ..... Date..................... PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with a'p• proved plans and specifications, and Building. Department notations thereon. Valuation ... ......... �' �r .............. Permit fee......... F-? ............... Recd. 6y... ........................ ` Building Department, By... ...:........Q.SJ.. ! ! r............. Date.-... ' J .. 1 j e i This Permit does not cover Plumbing, Sewer or Electrical installations. !- 1 ■