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CITY OFA ^144170 - BUILDING PERHIT APPLICATION <br /> Date Received: <br /> Total. Fee: $ <br /> Date Approved: <br /> Entered By: Per_nit-71 <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> --- <br /> THE APPLICANT IS: (circle one) cwNER or CONTRACTOR <br /> � ZIP. <br /> JOB SITE ADDRESS: T <br /> (work) <br /> pgONE: (hcme) <br /> NAME OF OWNER: <br /> CITY: ZIP: <br /> MAILING ADDRESS: <br /> L.o �.A LL E <br /> PHONE: ' l g O <br /> CONTRACTOR: <br /> MAILING ADDRESS: �vU�� <br /> cI TY: <br /> STATE LICENSE: n � � <br /> PHONE: <br /> ARCHITECT/ENGINEER: <br /> CITY: ZIP: <br /> MAILING ADDRESS <br /> REGISTRATION a <br /> NAME: <br /> Accessory Structure Move <br /> TYPE OF WORK: New Addition Land Alteration <br /> Demo <br /> Reamodel/Alteration�i Renovate <br /> PROPOSED WORK (describe in detail) : <br /> STORIES: SQ. FEET OF EACH POOR' <br /> NO_ OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> 1� <br /> ESTIMATED CONSTRUCTION VALUATION (eaclnding <br /> Land) <br /> permit and I acknowledge that the information <br /> I hereby apply for a building p that <br /> above is complete and accurate; that the work will be in conformance the <br /> ordinances and codes of the City and with the State Building ermit; and <br /> understand this is not a permit and work is not to start without a p <br /> e approved plan. <br /> that the work will be in accordance with <br /> APPLICANT'S SIGNATURE: <br />