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PROJECT 'fir u s- S Cc-k c-1-
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APPLICANT yv, S OWNER�C� I bn zl
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APN# 3 bl q ^/l U3 ,2- RES. (LVNG)
COMM. SQ.FT.(NEW)
(GARAGE)
T.I. SQ.FT. RES. REMODEL
n C o
CONTACT PHONE # YGl FAX
VALUATION --`
RECEIPT #
CONSTRUCTION TAX--------------(Y) (N)
SCHOOL FEES ------------------------ (Y) (N)
HC
HE
NC
PLN. CHECK
ENERGY
GRADING
SOILS
BLDG PMT
SEISMIC
ELECT
PLBG
MECH
ISSUED BY � -%� DATE �� � TOTAL FEES G