HomeMy WebLinkAbout4380 ZIEGLER RD - APPLICATIONS - 1/28/2003Company Name
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15 Mailing Address
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Phone
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JOB SITE ADDRESS
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Filing
N1umber
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License Number
City
State
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Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE.
Lot
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Number
of Bedrooms/Bathrooms
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Block
Number of Stories
Finished Basement Square Footage
Value of Construction (including labor, material, profit) $ C
Description of Work:
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Subcontractors:
Electrical
Roofing
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Mechanical
Concrete
Supervisor & Cert. #
Lot Area
Plumbing
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Zip Code
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Zip Code
Building Height
i nereDy acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contained herein and cit ordinances and state laws regulating building construction.
Signature
Print Name�i1��,��iy/ 41'02 -(140 Phone r 1?0- 6,63-G //2
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE