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JOB ADDRESS 58�B8keT
GENERAL CONTRACTOR �
AP No.11L1-061-04 LOT
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BUILDING P�RMIT NO.
VALUE S �.00
FIR� ZONE DESCRIPTION OF WORK
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40STA MESA BUILDIY� �AFETY DEPARTMENT
P.O. BO%919 COHTA MEBA. CALIFORNIA
For Appllcant fo Fill In Completely
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DESCR�pTION OF WORK
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APPLICATION FO�I��(� �E DEPT.
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NOTE: NO EAYE OVERHANG SHALL BE LE58 TNAN
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ALLOWED �U.B.C.REOUIREMENT:
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MAIN BUILDIN6 ACCESSORY BUILDINO
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