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" ' � CITY C1F OR'�L`NO, - BUILDING PER�IIT APPLICATION <br /> Total Fee• $ �7-�p� 1 � Date Received: � � ��� � <br /> Date Approved: <br /> Entered By: :(9,�Z� � <br /> Ferm�t r: �j�� <br /> AT•T• INFORMATION MIIST BE SIIBMITTED IN FDI,Z BEFORE PLA2�1 REVIEW WII�L BE STARTED <br /> (See Check-cff List Enclosed) <br /> -------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) O�VNER or CONTRACTOR <br /> JOB SITE ADDRBSS: GI(�C7 S�2CU,LUOUC �vo_c� nnono l�l� ZIP: ��39� <br /> (work) <br /> N� OF OWNER- �?n. and l%1��. 2vl�eat �len�vn PHONE: (home) �7/-7�'c46 <br /> MAIZ�ING ADDRESS: Same CITY: ZIP: <br /> CONTRACTOR: l n��.�e � �Yorrce Zmn n v v 2men _ pH��= �,Z?t���---n-- <br /> �v Qox ll2 CITY: Lonr� l_uh.� ZIP: S�?S6 <br /> MATI�ING ADDRESS: <br /> 000�845 <br /> STATE LICENSE: � <br /> ARCHITECT/ENGSNEER• Cv���n c� �inon,�en�, Znc. pgp�: L���_�l�/ <br /> MAII�ING ADDRESS: ��2 �umanach �ive CIq*y: L�n� L��e ZIP: �53�6 <br /> l��a n h .S. G Q REGI STRATION T l 2 7 S 5 <br /> N�g; nvnben <br /> TYPE OF WORR: New Addition Accessory Structure x riove <br /> Demo Remodel/Alteration X Renovate Land Alteration x <br /> PROPOSED WORR (desc=ibe in detail) :22nzvve a.�.� I-and coven �.C��i P�%nT���n^_ <br /> Qu�.Ld 2� ' x 26 ' attachea �arca�e- �u�.Ld cF' x 2� ' �ech - �n�ta.L.L ��ve new dovn� - <br /> bu�.Ld l2 ' w�de a��ha.Lt da�vewar.� - �vd �aad- aeta�n�n� cua.C.L a�. needed a.Lon� <br /> STORIES: SQ. FEET OF EACH FLOOR: a�n�vewu� <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT._�_ DET. <br /> ESTIMATED CONSTRIICTION VALIIATION (ezcluding Iand) : $ 28, 000 <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a p it and work is not to start without a permit; and <br /> that the work will be in ccordance with the appro,�ed plan. • <br /> s.: <br /> ��l � J �� <br /> APPLICANT'S SIGNATURE: DATE: <br />