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1986, 06-11 Permit 00011305 Inspect
INSP-ID /' f°'"' DATE '&4/-1)1 SIGNATURE OF OWNER OR AGENT APPLICATION DATE JOB ADDRESS OWNER: ADDRESS: CITY: ST: ZIP: APPLICANT: CONTRACTOR: ADDRESS: CITY: ST: ZIP: pH: LICENSEa: ARCH/ENGINEER: ADDRESS: CITY: ST: ZIP: PARCEL.: CENSUS TR: INSPECTOR: PLATA: LOT & BLOCK FINAL PLAT NAME: ZONES: ZONE FSB S•1 S - 2 RSB MOD USE OF PERMIT: JOD ADDRESS: PROJEC', PEES: COUNTER APP: PAID BY: A CK PLANS EXAM: DATE: INSPECTOR'S COPY