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CITY OF CRC:IO - BUII.DING FER:�.ZT APPLICATION <br /> iotal Fee: $ ��� ���/� Date Received: <br /> Date A��ro�ed: <br /> =ntered B� �'./L.' �. u. ���� 1 <br /> Pe�i� . <br /> �,T.T. INFOR''iATION MIIST BE SIIBMITTED IN FIILL BEFORE PI,�N RE�7IEL�1 WI� B$ STARTED <br /> (See Check-aff List Enclosed) <br /> ----------------------------- <br /> THE ApPLICANT IS: (circle one) L�Ti�1ER CONTP.ACmOR <br /> JOB SITE ADDR.$SS: � � C+ e�� v '`- ZIP: <br /> (work) <br /> _✓ � z <br /> - � PHONE: (home) � � � <br /> N�,ME OF OWNER- � ' � ��C '�/rl,�C���� <br /> MATLING ADDR.ESS• ��I � l�� �-'�l �''�/ CITY: �G/y C; G' � � ZIP: <br /> ��� �K �� �Jr°� L �r PHONE: ���'-��`�� <br /> CONTRAC�'CR: �, <br /> J�� Lrr��/,`'' �� CITY: � �tGZ� ZIP:���'� <br /> :��I�ING ADDRESS: � �� � � <br /> STP,TE LIC?�SE: = ����ti�`��( <br /> ARCHITECT/ENGIN�ER: P$��� <br /> C=Z•y: ZIP: <br /> :KAII,SNG ADDRESS: <br /> ���_ R.EGISTRATSON � <br /> ':'YPE OF WORK: i7ew Addi.tion Accessory St�ucture riove <br /> De�o R�*nodel/Alteration Renovate Land Aiteration <br /> ?ROPOSED WORR (describe in detail� : <br /> ���d`� � lL' �i'�� '�������' <br /> ,� ���� �2 Sc <br /> �TORIES s ( SQ. FEET OF EACH FI�OOR: <br /> �yp_ pg BEDROOMS: Gt�RAGE STAT�S- ATT. DE'�'. <br /> c�:, <br /> �—. <br /> ySTIMATEI7 CONSTRQCTION VALIIATION (excluding Iand) : S <br /> ���;� <br /> = hereby apply for a buil.ding permit and I ackncwledge that the infor:nation <br /> sbove is comolete and accurate; that the work will be in conforinance with the <br /> �rdinances and codes of the City and with the S`ate Building Code; that I <br /> :�nderstand this is not a permit and wor ' s not tc start without a permit; and <br /> �hat the work will be in accordanc wit he approved plan. � <br /> / L� DATE: � ��'� '�� <br /> �pPLICANT'S SIGNATIIRE: <br /> f <br />