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+ CI'rY OF CRC:IO - BJILDI27G FErrt.'�-I'i APPLICATION <br /> �� . , . <br /> Total Fee: $ ;,Z��1` �� Date Received: <br /> Date A�proved : <br /> =ntered B� � _ 1. ,-/ �; ' ." <br /> Pe�it - - <br /> AT.T. INFOR.'�iATION MIIST BE SUBMITTLD IN FULL BEFORE PLAN REVIEW WI� BS STARTED <br /> (See Check-aff List Enclosed) � <br /> --------------------- -. m _ <br /> �E APPLICANT IS: (circle one ) O�v�1ER or CONTRAC_OR � <br /> r, '4 �' <br /> 70B SITE ADDRBSS: J� �S L� � � ` 1 ZIP: �5 ! I <br /> (wark) <br /> :7� OF OWNER: � �-+-� y� �-- L\�^ r► �-'"�-- PHONE: (home) <br /> �AII�ING ADDRESS: CITY: ZIP: <br /> \ � <br /> CONTRACTCR: c.�'/�` l-- �-�`� "__��"`U i:.�/ c:� .ti� `�� c_ PHONE: %2-�j� C�' �/2� <br /> ,a �u-rti-, r��..� ���_. cI TY: d. l,c�,�s `r�.� Cc_ z IP: S5��.� <br /> ._ASZ,ING ADDRESS: �� l��� � , FJ �X <br /> STATE LIC�:`7SE: T <br />�nCHITECT/ENGINEER: PH��� <br /> .AIZING ADDRESS: CITY: ZIP: <br /> �AMF: R.EGISTRATION T <br /> ��� Accessorv Structure riove <br />=r*vpE pg y�;p�ZK: �7ew �f Addition _ <br /> Demo R�*nodel/Alteration Renovate Land Alteration <br /> � I/ f, ' �� <br />�ROPOSED WORR (describe in detail) - 1 � �`�x � • <br /> �� '� (�d <br /> �, � <br /> ��J 'Z .rX�e-„ -t�G� � � �.- <br /> �TORIES:__�_____ S4• F�T OF EACH FZ,OOR= `7'�7 `� <br /> :�70_ OF BEDROOMS: G�,RAGE STAI�I.S: ATT. DET. <br />?STIMATED CONSTRIICTION VALUATION (ezcluding Iand) : 5 13 �>C�== <br /> : hereby apply for a building per-iit and I ac?c.^.cwiedge that the infor:nation <br /> .bove is complete and accurate; that the work wi� 1 be in conformance with the <br /> �rdinances and codes of the City and with the State Building Code; that I <br />:dnderstand this is n a permit nd work is not t� start without a permit; and <br />�hat the work wil.l be i�t� acco a e with the approved plan. � <br /> C�n.�n. ^ <br /> DATE: � % �"' <br /> c'�PPI.ICANT'S SIGNA � <br /> � <br />