1986, 05-22 Permit App: 00011187 Pool •
(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)
SHADED AREAS ARE FOR DEPARTMENTAL USE
I Project Number
Owner's NameY1 LAST FIRST MI
f' C' �iS r /�i C4Ia&
Project Address(Street Name&Number) Zip
coo !I /�2 / 'pok e, Zi)ds4 2 lr /�
Applicant Address
City State Zip Phone
( )
Business Phone
( 1
Contractor/Agent Address
City State 1 Zip Phone
( )
I
Contact License Number(Required) Business Phone
( )
Architect/Engineer Address
City State Zip Phone
( )
Contact Business Phone
( 1
Lender Address
City State I Zip Phone
Describe Work Res. Comm.
-, r ">, 11-0 : ,) E- 6( U`ice) Poo ,_
Subdivision/Plat Name/Short Plat Number
r i \P
tll
Assessor Parcel Number Lot i 7.4414 Block Plat Number
Pertinent File Numbers Zone Comp.Plan Census Tract
Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage
Front Setback' Left Setback Right Setback Rear Setback R/W Width
Additional Information Square Footage
) P✓\11 d
Z _
O
I-
Q
2
ccO
tL
z
a
2
a
J_
m Writerof Bedrooms
.. ff: 4
az.
Building Technician - Date Group Type
. ...,......„ ..... .. . ., ,..
. • . •
. .
. . . . .
• •
,, . 1 ....., ...... r.,,. .., t ....... .... I„ .. .I ...1' -.. , .. .1. . .., • .. T. . 1.. J.. .-I ..... I -I. -• ••• , i • i. ••••,. ' 11.. I • I -: i.-. I-. •
.,.7- i 1 '. . t- - . - • . -•_- ' - .- i. 1 --i - .-:•T - ! 1 i• - T- • - -IL IL_ 1. -
1t .1-', -,1-'. - •I-i - -1--, • 1 • ' -- -1-.: i . - I If- - I I- - -1 - -- 71- 't. • - '-• -• •----':1
- - .-, -- , - IT" ' • .1 . - - 1,• •• •• ••••1. -, -
-•i 1 . I - .... i. , - I . • _ ___f_-___,,_ •i. . . •:. ; 1 .._____ • l• _r____ - .44_- _ 4. .. .• ._„....,
It\H ,-, , . t. - 1 1 1 , • i '
I 1 • , I - . 1H I i 1
, . , • 1, . . 1 , , , 1 1 rl i - 1 ; - , , . 1 1 1 '
. 11 , , ; 1
..,1_ i , ._____ , ; 1 _ -:,..1 , ; ., 1,_ ._ 4
-.- - f 1 . r ! - - i t . ---7--,----i
• ' • -.I H I -- I . 1 7 I ' I ;I' . 1 1 -4- '. • : . I 1: 1 .
•:! - -• - •• 1; • i -• I- - -•- • -- , . - • i .; ' • ; . ; - - • 1 , ; ;;: ,...-... 1 -
- 1 I ' ; • ' ; '- • 1_
_ _ I __4_ - . 1-1 1---- 1 .. . / -1-- 1 i ; 1 - -1------I
'. 1 ! ' ; ! 1 - -r I 1 - 1 1 1 • .1 1 ..';'. I 1 1 1 1- 1 • ' -1
;
.
I ii 1 il, i 1 , -1--- I t 1 I ir--1 I f i
i
: ; i i i. i 1 l • . ,
-,-- 1 : .;- ,.. _j„ ' •: - <
' . ,-----,--' F-
1 1 ,
7•-•----- " •-•-•---4,.._ . _:,.:,..._4,,.------ i -----"-- . -1- 4._ J; f__.
1 ! f 1- t- - / ---f + -,
1 ' '
H
41 . : I t
. • „ • '
1 ,
i
__;t____.. .__ , I 1 r --t- -1 f iti, - ir i-- •-,
. ! . ,
________=_ = _.__ ____i. . ,
1
; , I
, 1 1
,,-- -/- _ •1_
! 1
I 1 1
i----r----4- I..- I I ._... , •
_I..
: . 1--• 1 1-
i ' f
•-••••----- i---;•-t----1-- -1- 1------ , 1 f 4; / ---7.7--=---4---- • --1 ; ; f---- -,- ; . 4 :' t
, ,• ; ..- ;
_,.......__, ,_
„ 1
' ! 4 _411 1 !
4 1 '
1 1 1 11 -1 1 i• 1 ' - -1. ' -1.• ,
!
„...i 1:
! 1 ,
i ,
, , ,
i 1 1 I 1 f i
-i 4 -±
1 _1. ' .T
I I 1 1 T t -1-
t ' I • 1 •
_!_1' 11, i
1 1
il I
1 i 1
, ._..,
- ! j.-- _4__ ! • _
1 ' I • -1
1 1
I I 1 7-1--f-
I , , L TT
i I I T
. .
It'---- I -711 -III i --4
1 }; , 1 . . 1 •-.; ! 1. I
Hi I 1 17-1
1 , , : . ,
, • , , , , f 1 , ii , ,..)„ ! i i i, , i i
. : ; i i i i i ; }
i
\Li: 000t... - i , , i i , 0
- li! .171. • • r-1 -1-
! 1 1 I . i , .i. 1 ,
-1--.±---i- ---4-• i '' . • Li • • r 1._ 1 I 1 • 1 1
i I • 'II I. i . I I t 1 i 1 I 11
ill I - 1 1 • • , ,
I -14 i -it i
4 - ; I ;!---4-- .1 'ii
1 , 1 H, . , li ir _
; . 1 • ' 1 ! :
; 1 1 I
I i i i -4. .• ;
; ; 1 - ;
,
I, , ,
1 1 ! I ;
i .._:,,_, ,
iii — 1- 1 — L---1-- ii it , — tu! .t7 - t- • t 1 ' 1-- - -- 1-.1
, _
__A__
,. 1-
--,- ---, --,-- --,-- ; 1 I - TT -.
,
I 1. . . 1 , ,
I i 1 . ! 1-1----17 '
,. , , i I
. T --t,- 1 ___.! _______ _..,.
--. I _ -1---4- ----- I 1 I - t---T
1. . __._ i . .
1 i 1
1
' - -f- --t- ---1- -1-- : --i
. , t t , -i / •-/-••• - - r. 4 . ; .
•;_t i _, i t - --1- --------J--•••1
--1 1 , , , ,
1
I .
1 . . • i
I-_--JH -_-l. !I i 1 I
1 • ' i I '
I I 1 . ,
• I -
---4L 1 -----1--- I i - I-- 1 i ---f-- I • t I i I I- I 1
I 1 1 I
- -I 1 1 ---1 - -;- 1 1 1 ' 1 I
_ _4 __i_ i ' 1
__._ __ I - ___H
i .i ii. 1 - 1- 1
i • i i . I. . ....._.1 _
I , I -1 t- . .t. .4._.i .1 - -I I
• • • , i i
f , . 1 • 1 i. . 1 / 1 • ' 1 ' I: I I • /
--- „ 1, 1, . • i f 1 1I .. ,; 1 . ; , I
!. 1_ ___I__• _; 11 1 " ; '
+/- -- 1 I ; 1----1 -- . :1--L-1 1 - - i- - 1 I -. ;--i--- .
. I --- 1, • • '
• i 1 / 1- I 1' 1
-r-i 1 - i----1-1------1-----1---1 - i -H . 1 1 --±.-----'t 1 I I I I • 1 -
, ,
- •
• .
1 -