1986, 07-10 Permit App 00012047 Demo Residence(THIS IS NOT A 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)
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Owner's Name
LAST FIRST MI
Project Address (�Street Name & Number) Zip
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Applicant
Address
City
State
Zip
Phone
Business Phone
Contract /A
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City
State /rt,' //�/
Zip CY / !/s /�
Phone JJJJ
Contact
Lic ise Number (Required)
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Business Phone
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Architect/Engineer
Address
City
State
Zip
Phone
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Contact
Business Phone
Lender
Address
City
State
Zip
Phone
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Describe Work
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Res.'
Comm.
Subdivision/Plat Nar,/Short Plat Number
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Assessor Parcel Number
Lot I
Block
Plat Number
Pertinent File Numbers -
Zone /p'�/p �j
Alt,. ,
Comp. Plan
Census Tract
Number of Dwelling Units
Number of Buildings.
Lot Size (Sq. Ft./Acre)
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Depth
Frontage
Front Setback
Left Setback
Right Setback -
Rear Setback
R/W Width
Additional Information
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r BUILDING INFORMATION t'
Square Footage
Number of. Bedrooms
Building Technician
Date
Group
I Type