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PLANS MUST BE FILED AND APPROVED By THE
INSPECTOR PRIOR TO A PERMIT BZIN.G GRANTED
Build' Permit AppUeatioa For. Loatioa of>iwildlsS S S�" y '�/ S�
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'(Circle whichever applies) Root;Re asW Construct Dedc.Shed.Pod
Addi ' Altaid �/Raplasa.Foundation Only. Wred=S
. Other:
PLEASE FILL OUT LEGDILY& COMPLETELY TO AVOID DU AYS IN PROCESSING
To the Intpepor of Bui)diags:
The tmdagpod hoeby applies f"a permit to build aaordiaS to the tolloowwiM fpedSatloos
Owne ti Namr d/onn,n L s Cootraetor. o lam / /✓1�7�/*�/
Street_ �s�//,t� Ciq q ewl Suee►//( �er���adiP� City �H9
Snte4ae. Phone State Phone(,saw
Atthitea: �!7 n %�3e2 aty of Saims LWL LL-7
Street cil State LiaY O ,�w r�/__��C l
Stab Phase ( ) Homeowners Eaempt remea as
Stnrchre: (please citde) Single Family. Multi Family ti X ' -Other
Estimated Cat of job S 50 \\
Will bonding caafito to IaM _ems as �� .V
Aaaato.!__ ya_so /
Dtaeriptieeofwor�/kbbedare: ndd_!,[, wAj
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Drawiop S milted: no MAU Perak to:
zCOyi�/-4�r
re o<AP GNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BICOMPLETED wiTHDY SIX&MONTO OF PERMIT ISSUED DATE
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