1985, 07-24 Permit App: 00006519 Garage Footing(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)
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Project Number _�'/
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Owner's Name LAST FIRST MI
&0V\ BnberA A
Project Address (Street Name & Number) Zip
/J5a1 F, r-r-c,:\.r:c.c._ SPO AtnC2,, t..ICa_ 99aoc,
Applicant
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Address
I S a I C . FrEcLe- CAC
City
SQoiCAnc:
State
CJA.
Zip
9Rao(,
Phone
(SW 9a6 -3a35
Business Phone
(509) 9aq- /So o (633�Si
Contractor/Agent
Address
City
State
Zip
Phone
( ' I
Contact
License Number (Required)
Business Phone
Architect/ Engineer
Address t,
City
State
Zip
Phone
Contact
Business Phone ,
( 1
Lender
.Address
,
City
State
I Zip
Phone
( )
Describe Work
GAQA-GeFOOTucc_
Res.
Comm.
Subdivision/ Mat Name/Short Plat Number
110A e EAu RA -He it
Assessor Parcel Number -
09 sell - '0 /25 __ 2
Lot
4
Block
i
Mat Number
Pertinent File Numbers
Zone
A-asre a
Comp, Plan
Census Tract
Number of Dwelling Units
J
Number of Buildings
J.
Lot Size (Sq. Ft./Acre)
Depth
/20
Frontage
15
Front Setback
Left Setback
Right Setback
Rear Setback
Additional Information
L ' DEPARTMENT USE
Square Fogtago
51.32#
Building Technician
hia& -
Date -
1-0-85
Group
11- 1
Type
75
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1
Show on Site Plan: Additional Information:
Lot Dimensions Landscaping
Existing Structures Drainage Plan
Proposed Improvements Hydrants
Structure Setbacks Topography
Easements Lighting
Septic System (s) Signage
Water lines Shorelines
Sewer Lines Highwater Mark
Fences, Wells
Driveway(s)
Right of Way Width(s)
Names of
Fronting Street
Flanking Street
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Revisions: Attachments: