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1986, 07-10 Permit 00012047 Inspect
INSP-ID DATE i -__ JC SIGNATURE OF OWNER OR AGENT APPLICATION DATE JOB ADDRESS OWNER: ADDRESS: CITY: 5T: ZIP: APPLICANT: CONTRACTOR: ADDRESS: CITY: ST: ZIP: PR: LICENSER: ARCM/ENGINEER: ADDRESS: CITY: 5T: ZIP: PARCELS: (CENSUS TR: INSPECTOR: PLATa: LOT EC BLOCK FINAL PLAT NAME: ZONE=: 1ZONE I FSB 5-1 S - 2 R5B MOD USE OF PERMIT: JOB ADDRESS: PROJEC. FEES: COUNTER APP: PLANS EXAM: INSPECTOR'S COPY