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STREET ADDRESS <br />r .1 7 ' . <br />SUITE <br />'- F ' <br />RECEIPT NO DATE <br />non-n111 :It <br />PROJECT <br />.In On i n': 1 P <br />CITY <br />PI 1 -. 1 4H <br />STATE <br />IY; <br />TRACT NAML <br />III <br />USE OF PERMIT /APPLICATION <br />' 13 1 , I LB- I I ( 1121 F -1 CL1171 <br />APN <br />09 <br />BLDGS -UNITS <br />r I'';c9 00001 I' 0130 <br />STORIES <br />F , <br />OCCUPANT NAME <br />"'1.. :If 1'1 '111 <br />MAP <br />4 BLOCK LOT MOD <br />rIG I <br />. tl <br />PLCANT NAME <br />APPLICANT <br />(111 -'! F11 , .)Ir! <br />'ITlLn 'ul�l 11! <br />APPLICANT " 1- 12 1 <br />41r` T . _� t!1611 <br />CONTRACTOR <br />STATE LICENSE <br />STREET ADOWSS <br />SUITE <br />CITY LICENSE <br />GItt <br />STATE <br />ZIP <br />CONTRACTOR PHONE <br />BLDG OWNER <br />STREET ADDRESS <br />SUITE <br />CITY <br />STATE <br />ZIP <br />OWNER PHONE <br />ZONING <br />GEN PLAN TITS <br />PUD <br />LOT SI /E E/A <br />CENS TRACT SIC CF IRS <br />GEO REF <br />F58 058 R58 <br />BSB PLANNING INT ENGINEERING NT <br />PLANS RECEIVED INT <br />PAID BY <br />FEES <br />ILL00I F+L ICIiL <br />1 /MAI - 111 ;:1 <br />.. 5 11F IfIr''Et) FNC4 PRIIJFZ PAGE •• <br />I ur ren t 1 4459884 <br />/1 ‘.../ <br />r J <br />l , <br />APPLICANT <br />'01 fit <br />flop I / Pe, r rill t <br />4 3)unt on <br />1 F'. <br />Foe <br />F -: - - <br />'_'96.59 <br />796,59 <br />Y96.59 <br />.._�� °R.:ml.� �.._...e..r_e_.Ce.... <br />OWNG.sLno INCMMigM <br />w ▪ oas . ».o. r •rwm <br />neaudiees <br />Wpr a....m, .... :.... .a e,r _.._ .. s <br />.. ...�...........r.�n,..r •ur. • <br />PLANNING STREETS <br />841.8020 841 -8066 <br />ENGINEERING WATER <br />841.8041 841.8071 <br />CITY OF PLEASANTON <br />P0.1305 520 • P1. EASANTON. CALIFORNIA 94566-0802 <br />e.. inr,r.urr. wMGV800Y DECLARATION <br />p" um <br />pr�rr•w•rr..ur.w...ru.•. e.r. <br />Ows <br />PUBLIC WORKS BUILDING INSPECTION <br />847-8195 (415) B47-8015 •(415) 847-8149 <br />FIRE (011108) (Recorder) <br />847 8114 <br />