1986, 10-27 Permit App: 00013850 Siding lrltll.
•
(THIS IS NOT A 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
IProject Number /J 18Ce
Owner's Name LAST � FIRST MI I— .XJ
7f a7
Project Address(Street Name&Number) Zip
/5 , 2 -, 7- 87-`4 (1)1(-) .
Applicant f
�l <^1 YL Address
City State(i) /7Zip Phone
. 9 9637 ( ) 9�6 , 7/ 0
Business Phone
( )
Contr/actor/Agent
6L.-6- 4
Address
a-L
City State
ZIP Phone
ilz.„4..
(
Contact License Number(Required) Business Phone
Architect/En"gineer) (Y�"�.'¢/ ii)/_ -G'T/-/ -eg5/ /� ( )
UAddress
City State Zip Phone
( )
Contact
Business Phone
( )
Lender
Address
City State I Zip Phone
(
Describe Work Res. Comm.
Subdivisionl/ N e/S rt Plat Nu pp VIL d,_.--
. Kt) tt o tG f�C"
F t.� AcPeTis
Assessor Parcel Number /�� Lot Block Plat Number
Z'/5'/3 — 02Qse 8 2.-
Pertinent File Numbers Zone 43 Comp.Plan Census Tract
Number of Dwelling Units Number of Buildings Lot Size(Sq.FFt./y/..Acre) Depth Frontage
45wtlJ
Front Setback Left Setback Right Setback Rear Setback R/W Width
Additional Information
.‘ ,' << i J' d C? Square Footage
--.. . .
0
P
k t, z
,t
v
t1 Z
D
m Number of.Bedrooms
Building Technician 'Date G
Group Type '