17 WEBB ST - BUILDING INSPECTION •�.hM
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PLANS MUST BE FILED AND APPROVED BY TSE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Lacadw of Bedding
Building PerdbAPPI�� For.
'(Circle whichever applies) Root Reroof, Install • blg d, Pool
Addition, Alteratio Repair Only. wreck s
Other:
PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING
To the hupepor oi'BuWdiup:
The rmdmsiSned/hlenreby applies for a per/min to build aaordinS to the JbIllowioj aped8atiorts:
Oweat+Naoe�"1 r C�. ��lA� Contractor._ -1�Q2G(e /✓� H
Stratl� n n�h G City a Oa Sueet_(n Z ytj.Qr%Cityllf�M/C rn�
Phone ( ) Sate r� Phooa(q-m) 771—S-PrV
Architect: City of Salo Lief! �
Suet City State uco 7 S�w 0
State,4�� Phone ( ) Hoataoweers Exempt Fors�as eo
Stnrdero: (piease cirde) S41c Family. Multi Family# _Other
Estimated Cat of job S pop
WW buildieE edits tow. !� a
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Dmwlop Submitted: ..�rss� so Mail Persil to: ��
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Stpta m d Appligtioy$ GNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BMOMPLETED WITHIN SIX(Q MONM=OF PERMIT ISSUED DATE
Depertttteat use only: PUM40�_ Zoa4tg
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permit bee= .
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