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JUN-.10-2002 15:39 P.01/01 <br /> O Date Received: • D�o� <br /> Tocol Fee: o <br /> �Sy: Peraut#-. <br /> i ,.. <br /> CITY OF &R0110 -BUILDM pERM1T APPY.xCATIO�t' <br /> Au jnf0vnaA0U must be nbmined k,hu•before plan review wrll be Mart+ d. <br /> (please print all if►}jormadon) <br /> TIM APPLICANT IS: (circle one 0 R CONTRACTOR <br /> 5. <br /> JOS Srm ADDRESS: w �X7-o��•J -�3 �'�f� ti'; <br /> NAM or OWNER-. "Tb.,,, )ZVA ti PINE: (home) <br /> (warp lots :S'9`3-.fit/cb <br /> MAILING ADDRESS: a.1 ys r,.)A <br /> CONTRACTOR: PRONE' <br /> MOSREMAGRR: <br /> CONTACT PERSON; <br /> G ADDRESS: <br /> STATE LICENSE= g_ <br /> �r r ' <br /> ARCMTEC`rW4GVWM-- PHONE: <br /> MAII.ING ADDRE.4S: <br /> REG I31'RATION# <br /> NAAiIE: <br /> A*W101n Accessory St uctu e, <br /> TYPE OF WORK: New _ __-- •.�;�"''; <br /> Move Remodel/A l�ttadon Lad AlteradtY n <br /> r <br /> PROPOSED WORK( describe in detail): C�� � �C'�O 'C�� <br /> � � <br /> sTox s. SQ.FEET OF 94CH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. <br /> F,WVAATI&D CONSTRUCTION VAUTAMON 1900- <br /> Aff�'T <br /> lm and <br /> for it and I awledge that the information above <br /> Y l:ueby apply buildiuS Pte' '• " ' <br /> acewm; that the work will be in conformame with the ordiumes and codes of the Cuy apt with <br /> the State BuUdittg Code: that I mWcr=W this is not a permit 20 work is not to start without a <br /> permit; and that the work will be in aecardwkt with slit approved plan. <br /> APPLICANT'S SIGNATURE: ATS: ' <br /> M , <br /> NO3'El E�.yd .gr ibmes even&require tganrnte pom t app-oval by pond DD"mxeid and <br /> events will not be atiawed. <br /> Ce'l)►council 60 days prior to the event. Nrgeperm�ed <br /> TOT <br />