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1986, 11-12 Permit: 00014085 RemodelPROJEC1ow SED. DATE: 0001408r. t !i{] Code 1- ! I .. SIGNATU,rRE OF OWNER OR AGENT DATE APPLICATION JOB ADDRESS. /Pe OWNER: ADDRESS: CITY: ST: ZIP: APPLICANT: CONTRACTOR: ADDRESS: CITY: ST: ZIP: PH: LICENSE#: fj j' WC ll0F2.I. ARCH/ENGINEER: ADDRESS: CITY: ST: ZIP: PARCELs: CENSUS TR: INSPECTOR: PLAT.: LOT & BLOCK FINAL PLAT NAME: ZONES: ZONE FSB 5-1 5-2 9513 MOD USE OF PERMIT: JOB ADDRESS: u1iding Code Fee oUiLDING 1.K l.i1FaRY `. TRUCTURE ; ::iLt.;ONDARY STRUCTURES: STRUCTURAL FEE5: PAID BY: COUNTER APP: PLANS EXAM: DATE: 1MODcn'rnu'c+ nnov TOTAL F• EE. TOTAL.. FEE Permit Fee J ' 1' $1,50 $.100.00 100,00 0 INSP-ID V1) DATE O J 2 U w 2 0 w CC z a rr3 u 7-e.;\ S") /1 - J