3984 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALI_ POINT PEN ONLY
BU LDIN .PROJECT I DENTIFICATI ON PERMIT NUMBER
BUILDING APPLICATION & PERMIT 3984
ADDRESS
4 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL
OwNER'9 PLAN CHECK VALIDATION
NAME
7l[ftOTV. ELECTRIC PERMIT FEE
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CONTRACTOR S
NAME nn- ,�,//,, UTLETS-SWITCHES-RECEP 5.00/1.00
C C1J/sClc.No. �7'SaG01� LIGHTING FIXTURES 5.00/1.00
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