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1986, 06-19 Permit 00010152 Inspect• INSP-ID DATE S v w 2 ww J_ m 0 2 0 -J w um Z a U en IGNATURE OF APPLICATION )WNER OR AGENT DATE OB ADDRESS I WNER: :ITN: ST: ZIP: \PPLIC ANT: :ONTRACTOR: iDDRESS: :ITV: ST: ZIP: 'N: LICENSE:M: 1RCH/ENGINEER: \DO RE SS: :ITV: ST: ZIP: 'ARCEL*: CENSUS TR: INSPECTOR: 'LATa: LOT & BLOCK FINAL 'LAT NAME: !ONE.: ZONE FSB 5-1 5.2 R5B MOO ;•:::,i VAN.; r(,I,LE. r. JSE OF PERMIT: 1012 ADDRESS: I'i i.I PROJEC' SEQ. tl!: DATE: FEES' PAID BY: G N COUNTER ARP: PLANS EXAM: DATE: • • IMODCt'T/ID'Q f'f1DV