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Jun-27-20�3 10:44am From-CITY OF GP.ONO +952Z494E16 T-725 P.006/009 F-650 <br /> Total F ��'�L�` ��� �' � DaCe Received: � - --L� � <br /> ee: $ <br /> Enr.ered By: }�1- z' i ��l C-`� Permit#: 0��5� 2-- <br /> �' �I I�4�� CTT'�' (��' QRONU - BC.�'gI..DTI��TG PERMCT �FLYC 4T�QN <br /> �,U� <br /> A11 informafion must be submitted in full be€ore plan re�view will be started. <br /> {please print all information) <br /> THE ,�PPLICA.I�^T IS: ~^(circle one) OVrmTF�Z OR C4NTR.�CTO� <br /> sOS SIT"E ADDRESS: v�-� � �1 S���' w��� <br /> k ��C ZIP:_ -���� I <br /> �tiA��E OF O�'��rE�t: W�"� -r S�4�� I>c n�}` ,��( PHQh'L: (home) gs Z- y�I ' 3£3 7 3 <br /> � (wark} <br /> :��,�cvG�n�x�ss: ��� � 5�,.�,�.�.�w��� �crr�: ��v z�: ss3 <br /> CV�1 iV��T�lt: �..+C.S �/r 1 C�`J `f' -X3.�J s �^.�.J�J L. ri.LOl�{Lr: �p�' ��CJ lLn ��/� <br /> CO'r�TACT FERSGN: • t� ?'viOBI��/PAG�ER: �i z-���r- Scx.�s _ <br /> n-�a�r.LVG Ann�ss ��z ���,�,�u�� T�.�;r crr�: �,��,�<< ����-�� <br /> ST�TE LICE:�TS�: # {�o f <br /> ARCT�I'�ECT/E1�'(YI�TEER: �Q?�: <br /> NLA�LII\G�ADX)R�:SS: CITY: ZIP: <br /> '_�I��IE:� REGYSTTittATI�N# <br /> TypE p� �i'pg,K; Ne'�� Addician � Accessory Structure <br /> Ivlove Remodel/Altera4ion La�.d Alzeration <br /> PR4POSEY7�TO�(describe tn de1'af�: /�rur�,��� �l��.v�, �-' /�'� �r-c_.r�t►r t <br /> �+ / , <br /> l'��q 5��/ /j-c - l a J nJ�,r - �, <br /> sTo�s: � sQ.�T o���c��oa�: _6�6 ___.� <br /> I�'O. QF BED'RO()1J1S: �j_ • G.4�.A.GE STALT�S: ATT. DET. <br /> �STL�IATED CO�tST�tUCTION VAT�CJATI�N (exclnciii�g land): $ �j'la U,q.� C� <br /> T hereby apply for a buildintr perrnit and I ackrnoR�led�e tt►at the information above is complete and <br /> accura�e; tl•lat the work will be in confortnance with the ordinances atid codes of the Ciry aad�zt3� <br /> the State Buildin� Gode; that 7 understand th.is is not a pemiit and work is not to start without a <br /> per�.it; and that the 'work wi1I be in accordance wi the approved plzn. <br /> APPLICANT'S S�IG�rTATL312�E: � � Gv�� T}ATE- �- ?- d � <br /> , hTp�'E� �'ar�e cf�-Inmes events require separafe permit approval by PoIice Depurtmertt and <br /> City Council 60 days prior to rhe evenr. Non permitted events will not be aI�oived. <br /> 5 <br />