1986, 07-14 Permit App: 00012088 Siding(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
Owner's NameLAST FIRST MI
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Project Address (Street Name 8� ber) Zip
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Cityl
State Zip
Phone
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Business Phone
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Contractor/Agent-.,,,\
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City �/
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State I Zip
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Phone
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Contact
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License Number Re uired)
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Business Phone
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Architect/Engineer
Address
City
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Phone
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Contact
Business Phone
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Lender tk
Address
City
State I Zip
Phone
Describer
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Fier.
Comm.
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Assessor Parcel Number
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Lot
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Block
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Plat Number
Pertinent File Numbers
ZoneAasuCi
Comp. Plan
Census Tract
Number of Dwelling Units
Number of Buildings
Lot Size (Sq. Ft. /Acre)
Depth
Frontage
Fronts etback
Left Setback
Right Setback
Rear Setback
R/W Width
Additional Information
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BUILDING INFORMATION
Square Footage
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Number of Bedrooms
Building technician
Date
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Group
Type