1986, 09-22 Permit App: 00013248 Siding r (THIS IS NOTA PERMIT)
• �""UILDING 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
Project Number:' ,� J L.yee .
Owner's Name LAST FIRST MI
`
r a /y/'t u 1,
Project Add ess(S t Name&Number) Zip
i
/ 9/7 ,C ' / X77/// (///07. - /yam/
Applicant / Address
Al-c-e// , ., //17 1)- 1-4.e...d-,-)<_% I g. /. (9/7 4 a
City ate I Zip Phone
7a . ' irk 1 7tC2/& ( )90, 6 - 79 fQ
Business Phone
l )
Contractor/Agent I Address
&"-±6-2,.., 1 -. /6 &-' a/-66.42,6,4_e_____
City L!/ State Zip Phone
Contact License Number(Required) Business Phone
( )
Architect/Engineer -- --- Address
City State I Zip Pnone
l ( )
Contact Business Phone
Lender
Address
City State I Zip Phone
1 ( ) —.-----/
I
Descrfbe Vork • .� Res. Comm.
J C
- iM /Short Pi: N! ber
AJtpele.3
Assessor Parcel Number Lot Block Plat Number
62541-1 - Z7C 1 1. •
Pertinent File Numbers Zone A ., Comp.Plan Census Tract
Number of Dwelling Units Number of Buildings I Lot Size( +Acre) Depth • J Frontage I
l ^V
vil,f4v:tbac,k,;:, "- Left Setback Right Setback Rear Setback R/W Width
AdditiOnal InformationSquare Footage
n
Cl iCL $ 3F?8 t
o (U ° " / ° — 5". ' Z
•
Z
0
0
J
5
Y m Number of Bedrooms
A
BtdldingTedmkiian Date Group Type