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d � <br /> f <br /> CITY OF CRC2I0 - BUILDI�IG FER:�T A.PPLICATION <br /> � � <br /> Date Received: G'��� �/l �� <br /> 'otal Fee: $ � <br /> Date A�procec: <br /> vZtered ��: Per*nit r: :,�; _ r. <br /> =1,.L INFOR'+ir�TION MIIST BE SUBMITTED IN FULL BEFORE PI�AN REVIEW WZI..L BE STARTED <br /> (See Check-Qr"f List Enclosed) <br />-------------------------------------------- <br /> -^HE A.PPLICANT I5 s (circle one ) OS�IER or CONTttACTOR <br /> ��B sz� �D�ass: ' - <br /> � ' � � /'� zzP: �S �-�' -%� ��� <br /> , <br /> 3�-�/8- a3 3S� ���'c� (work) l"1( �- �='G�/�. <br /> ,;�ME OF OWNER- ,��,� �� jJ'1E �-� y������ PHONE: (home) �7� ---�j/�.� <br />:�AII,ING ADDRESS: � ` � `� CITY- / (C' '�) �' ZIP: .F .5 ��`�= /�� 7� <br /> .JNTRI�C�'CR: � � � S PHONE: <br />:��I,ING P.DDRESS: CITY: ZIP: <br /> :'�A�E LIC�7SE: T <br /> /;) <br />'�.RCHITECT/ENGINEER: PHONE: <br /> XAILING ADDRESS: CITY: ZIP: <br /> ,��: REGIST�TION T <br /> �'PE OF WORK: New Additiar. Accessory ructure r!ove <br /> Demo Re_nodel/Alteration Renovate� Land Alteration <br /> � <br /> �' �-� —� �2�? -�,� <br /> '_?OPOSED WORR (describe in detail) : ` - <br /> � <br /> '""ORIES: SQ. FEET OF EACH FZOOR: <br /> ;p_ pg gSDROOMS: G��RAGE STALI�S: ATT. DET. <br /> ��-��J= � h-?�-��`�"SS D ��n <br /> ;�T=MATED CONSTRIICTION VALIIATION (ezcluding I.and) : $ <br /> �:.: ,�� , <br /> hereby apply for a buil.ding per.nit and I ac?cncwledge that the information <br /> �ove is complete and accurate; that the work wil ? be in conforinance with the <br /> _-dinances and codes of the City and with the S�ate Building Code; t�at I <br /> aderstand this is not a permit and wor:c is not to start without a permit; and <br /> .Zat the work wi11 be in accordance with the aporoved plan. � <br /> /� , _ �-� � � 4; � � <br /> .,�PLICANT'S SIG�7ATIIRE: ��- r . c_ DATE: � <br />