116 HIGHLAND AVE - BUILDING INSPECTION nett: —
Cttp of `4ali 7t, jolam9aLbU!9Ett$
PLANS MUST BE FILED AND APPROVED By T)HE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Balldio Permit Location d Baudiag �6 6
� APplkatioa For.
'(Circe wbicltever applies) Root;Rcmf, !oaten Siding,Conmuct Deek,Sb4 pad
,/U� n. Faugduioo Ol y, Wrecking
Otlter:-•---r—�� non �d.-,
PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCBSMG
To tba lntpepor of Bui)digga; '
Tbo 04MiPW baeby applies for a permit to build scow ing to the following spad6atlons
Owueri Name }*m Itlrr- S Coatraetor
Street Jul v city Leis, Strog1LS
seteL.°L� Pbane ( -7U�- 3bS-� Pbooa( j3�p73y0
AnbiW' Gty d Sttiam Lim ,
sow city state W /7 w me r
stw Pbone c ) Homaowoeta Eaompt Form__yea�ta
Sttmwtre:(pease ttirde) Singe Family. Multi Family f-Other
Eaimated Coat oflob S / vQo.
WW Wdl"g Comm bow!
Doedptift of;W c be dm._X1,'Ca)
Drawn t Subminw: 00 Mail Penh to:
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Sipam'm of AP " , NED UNDER THE PENALTY OF PERJURY
CON TRUCTION T B OM\P�LETED WPI'lIID SDC MONTUS OR PERMIT LSSUED DATE
Depo:u::mt use nay Pet:ait r \��
Permit fee s�
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