201 S Park Ave - 94-001440 (INTERIOR & EXTERIOR REMODEL) (A)g ac)
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CONTRACTOR
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ADDRESS
PHONE #
LOCATION
OWNER E°'lU 6 li tA
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PLUMBING CONTRACTOR S
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PHONE # z
ELECTRICAL CONTRACTOR�S+6�-�'�-
ADDRESS
PHONE #
MECHANICAL CONTRACTOR- '-
ADDRESS
ADDRESS
PHONE #
MISCELLANEOUS CONTRACTOR
ADDRESS
SEPTIC TANK PERMIT NO.
SOIL TEST REQUIREMENTS
FINISHED FLOOR
ELEVATION REQUIREMENTS
ARCH IT ECTURAL APPROVAL DATE:
SUBDIVISION:
PERMIT # +' �`� _ l C
JOB 7 ``T- E'_ _Yvc
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COST $
FEE $
STATE NO.
FEE $ h )
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FEE $
FEE $3(3
LOT NO.
BLOCK:
SECTION:
SQUARE FEET:
MODEL:
OCCUPANCY CLASS:
INSPECTIONS
TYPE DATE OK REJECT BY
FEE $ ENERGY SECT.
CERTIFICATE OF OCCUPANCY
ISSUED # DATE:
FINAL DATE
EPI:
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