HomeMy WebLinkAbout1985, 10-07 Permit App: 00007899 Barn(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
Owner's Name
LAST
7�?ly /►c,
FIRST
F/N
MI
Project Number
Project Address (Street Name & Number)
Jif E 4R
I:
Zip
Applicant
c1 C-.
City
.5.P r. E
Gc;WS 7/ Lf L ( .41
State
4s
Zip
Contractor /Agent
Zip
License Number (Required)
Address
�. .23e'? 5c/ �r
Phone
�) -7c.*
Business Phone
Address
Architect / Engineer
Contact
Lender
Zip
Address
Business Phone
(
Address
Phone
4.0