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HomeMy WebLinkAbout330 W Myrtle St - Applications/Deck - 04/20/2004Last First, / Middle Phone CDStreet Address Please Specify* LN. DR. CR. WY. PL. ST CT. RD. AVE. City State Zip Code Comp y Name License Number Supervisor & Cert. # cmy R ailing Address City State Zip Code Phone 3/4"7 r04 Please Specify. LN. DR. CR. WY. PL. ST. CT RD. AVE. Zip Code JOB SITE ADDRESS Subdivision/PUD CM Filing Number Lot Block Lot Area Building Square Footage Number of Stories Building Height 0 0 Number of Bedrooms/Bathrooms Finished Basement Square Footage 0 C� c Value of Construction (including labor, material, profit) $ Descriptio of Work: Subcontractors: Electrical Mechanical Plumbing Roofing Concrete Framer I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements con ined herein and city ordinances and state laws regulating building construction. Roe -a Signature a Print Name Phone Distribution: Original — L & P Yellow — Office THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE