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2003-P06822 - re-roof
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2475 Countryside Drive - 04-117-23-11-0006
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2003-P06822 - re-roof
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Last modified
8/22/2023 5:05:53 PM
Creation date
4/29/2016 2:51:13 PM
Metadata
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Template:
x Address Old
House Number
2475
Street Name
Countryside
Street Type
Drive
Address
2475 Countryside Dr
Document Type
Permits/Inspections
PIN
0411723110006
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Updated
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Total Fee: $ Date Received: <br /> Entered By: Peruut#: <br /> CITY OF OIZONO - BUILDING PERMIT APPLICA.TZON <br /> All informatiou must be subznitted in full before plau review �vill be started. <br /> (please print all inforntation) <br /> ---------------------- <br /> THE APPLICA.NT IS: (circle one) OWNER OR CONTRACTOR , <br /> JOB SITE ADDRESS: �` � I �� <br /> � �7� � ZIP: _� �~,� � � <br /> ��I <br /> NAI�� OF Oti�NER: n i� � <br /> ��c� � r,�.����� ��r�-P PHONE: (home) �1Sa-���5 � <br /> (work) <br /> I�IAII.ING��.DDRESS: . CTI'Y: ZIP: <br /> CONTRA.CTOR: � SE�ROOFING&REMODELING P�IONE: �'1, <br /> ��-�a��X�y�� <br /> CONTACT PERSON: SIOR BLVD. 7ZOBII.E/PAC'rER: <br /> MAILING A.DDRFSS: -�#A�A��^ CIT`Y: ZTP: <br /> STATE LICENSE: # <br /> ARCHI'I'ECT/ENGliYEER: PHO\TE: <br /> NIAILL�IG ADDRI;SS: CITY: ZIP: <br /> �T��� ` REGISTRA.TION# � <br /> TYPE OF tiVORK: Ne�v Addition Accessory Structure <br /> Move Remodel/111teration Land Alteration <br /> P�ZOPOSED tiVORK^(describe in detai�: - '� ��.,, '� �-� Q C� <br /> --�'�`�-�- � `� `� /\�e , � � � �c " P S <br /> STORIES: SQ. FEET OF EACII FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT�. � DET. � _ .- . .. ., <br /> ESTIttiIATED COti'STRUCTION VALUATIO\ (exclucliug land): S �.�`��\ <br /> I hereby apply for a building pemut and I acknowled�e that the information above is complete and <br /> accurate; that the work �vill be in conformance with the ordinances and codes of the City and with <br /> the State Buildin� Code; that I understand this is not a perm.i[ and work is not to start without a <br /> permit; and tha[ the work will be in accordance with the approved plan. <br /> A.PPLICAN'I''S SIGNA'TUIZE: �� , - � <br /> DATE: �_ �-- � - 1 <br /> 14'OTE! ,Parade of HomeE events require separate pernrit c�pproval by Police Depgrfinent and <br /> City Cou�tcil 60 days prior to the event. Non permitted events tivill not be allotived. <br />
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