1986, 12-30 Permit: 00014632 Wood StoveSIGNATURE OF
OWNER OR AGENT
JOB ADDRESS
APPLICATION
DATE
PROJE
SCO
DATE
FEES:
PAID EY:
COUNTER APP:
J
PLANS EXAM:
DATE:
sr
INSPECTOR'S COPY
OWNER.
ADDRESS:
CITY. ST: ZIP:
APPLICANT:
CONTRACTOR:
ADDRESS:
CITY: sT: ZIP:
PN: LICENSE s:
ARCH/ENGINEER:
ADDRESS:
CITY: 5T: ZIP:
PARCEL.: 10EN5VS TR:
INSPECTOR:
PLATS:
LOT & •LOCK
FINAL
PLAT NAME:
ZONE.:
ZONE
FS■
5-1
5.2
RIS
MOO
VSE Or PERMIT:
JOS ADOR[55:
APPLICATION
DATE
PROJE
SCO
DATE
FEES:
PAID EY:
COUNTER APP:
J
PLANS EXAM:
DATE:
sr
INSPECTOR'S COPY
1NSP
DAT
70
r
+ �`
r2-o'r &+
BLDG
PLBG
MECH
306
j MOBILE
HOME
RE LOC
SIGN
U
[ROJECT FINAL