1986, 06-04 Permit 00011372 InspectSIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE
JOB ADDRESS
OWNER:
ADDRESS:
CITY: ST: ZIP:
APPLICANT:
CONTRACTOR:
ADDRESS:
CITY: ST: ZIP:
PH: LICENSE.:
ARCH/ENGINEER:
ADDRESS:
CITY: ST: ZIP:
PARCEL=: (CENSUS TR:
INSPECTOR:
PLAT.:
LOT & BLOCK
FINAL
PLAT NAME:
ZONE.:
ZONE
P50
5-1
S-2
R50
MO0
USE OF PERMIT:
JO0 ADDRESS:
PROJEC
SEO. #:
DATE:
PEES:
PAID OY:
COUNTER APP:
PLANS EXAM:
DATE:
INSPECTOR'S COPY
INSP-ID
DATE
J
CO
Li'
2
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U
0
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