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iiG•��3-97 ii�: -iG FA1 61� 3�1 ii:s�3 ZI�IbIERhIAN GROLiF �iiii� <br /> ciTY c�F ORON4 � 6'i247305'la 06/22/97 a7:55 � .02/03 No:40� <br /> Totai Fee: $ z�' �°� D�ce Rex.eived:, .(�� — a2 3 - `f'"� <br /> Entered By: ,� — Permit�: ��L� �' — <br /> ✓ <br /> CY'TY OF �RC�N� � ��I.DIN� P��T APPLICATIdN <br /> A111n�nrmation must be �ubmitted in fu11 befa�e plan review will 6e started- <br /> � (p�lr�sc print a.11 i�'ormatlon) <br /> THE APPLYCAN'T IS'; (ctrcle a��) OWNER R CONTRACT�R <br /> JOB SITE AUI�R�'S.S_ � � �.S l ��c �+� .:�. ..�� f?� 2IP: -� `� .��� <br /> 11Rsir`.-' Vi' �MVI\�.R: �./ r �4 � r''� '.1 C � 1 t 4 �il�l\i7r. ���1 ��� � C� r� � <br /> _ �wOrk) ..3 �'/ — r�a � <br /> MA�I.IrtG ADDRE.SS: /�`�'' � c CI�'Y: �IP: . <br /> CUNTRAG'Ti]R: � �r/. �/ 4-.�a a PHONL: �`7'/ = �'� � .� <br /> CONTACT P��SON' l� ��� � � � J `�'fO�A�E/PAGER: <br /> i�A�T.IN'G�iDDRFSS: /�� � � Fo —�► � .: CITY: ZIP: � <br /> STA'1'& I.I�CENS�: �+ <br /> ARGYg1TECT/�NGINEER: � ���' � � PHONE: _ _ <br /> MAIL�G ADDREL�S: CITY: ZIP:� <br /> N�►�: REGI�TTtA'TION# __ , <br /> 'Y'XPE OF 'WORg: New Add�tian � Accessary Sauctur�_:�. -- <br /> MQve 1�mad�UAlteration L�nd Alrtration � <br /> a � f a c <br /> PRdPUSED WUYtK (descr�be fn detal�: �� G��r� , � /� <br /> 7,� � " ti � ��� �� � - <br /> $TURIFS: S�. F'�E'Y'OF EACH�'I.�R: <br /> NO. QF $EDROfJMS: _ _ GARAt�E STALLS: ATT. DB'F.. _ _ . <br /> �:STIlti+tATED C�IVSTRUCTIdN VAX.UATION (excluding land); $ �/.� � ° Q <br /> �hereby apply far a�,uilding permit end I acknowled$e that the inforn�ation abave is cornplet� and <br /> accur�tc: thgt the work will be i� conformancc witb the ordinances and codes of i�e City and with <br /> t,h� Stat� Buildi�g Cod�; thnt I under6tand th�s is n�t a germit and work is na[ to start .�'iih�ut a <br /> pern�it; and that the work �uwi11 be in accorci�ncc with the approved p18n. <br /> APPI�CAN'�''S 9YGIYAZ'URE: �'" ,= DA'i'�: �� ��-��� � � <br /> �r�r�1 irts r 'r� stparrrt�pernr�! appraval by Po�te l�epart»eent and <br /> C�1y Counc�i bp days p,r�or ta the ever�t. Non perm�tted cverYts wtll not be aYlowcd. <br />