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�;� �� 52� <br /> � �j <br /> Total Fee: $ �% v Date Received: <br /> � �,ntered By; !'` Petmit�#: <br /> , <br /> CITY (�F ORO1oI4 - BUILDING PERA�[T APPLICATYOI�T <br /> All information must�e submitted in fuil before plan review will be started. <br /> (please print all informatzon) <br /> �-------��-----�-------- ----- <br /> T�iE ,t�PL,ICANT IS: (circle ane) OWNER OR CONTRACTOR <br /> • �,_ � � <br /> JOB SI7'E ADDRESS: .Z-C�3� C�",v,-�� , G � __ ��: �s �� � <br /> NANI� OF OWNER: �p ���u�l���`'� ��N�`�� PHON�: (home) <br /> ' (vc�ork) <br /> MAILING AI)DRFSS: ��-�-- CYTY: _ -- ZIP: <br /> CONTRACTO�t_ , ar.� 25�:-, �` - � � 1�,�� .sPHONE: 7(0� 'S-�'3c53s"- Z <br /> CON'TACTPERSON: '� �,qti MOB�I.E/P G�ER� �v( Z- z-2 i - ���� <br /> MAII.ING ADDRI:SS: ��lyo y2rJ-� �- �� l�,�a _CTTY: �aa;.�-���F��` ZIP: �;5 y z z <br /> STAT� LICENS�: �l 2:3��Z- _ <br /> ARCHITECT/EN�GINEER: P�QNE: _ <br /> MAIL�NG ADDR�ESS: CITY: ZTP: <br /> NAME: REGISTR.ATIQN#1 _ ;���� <br /> � ��, ��C <br /> � <br /> ��� <br /> TYPE OF WOR�: New Addition Accesso[y Strucriue . � �� <br /> N1ove Remodel/Alteracion � Land Alteration ��-- <br /> -..��`�\� � � <br /> PROPOSEA WOYZK(descri6e in derai�; ��:Y--��.-�= 2- ��s 1-,z� ��� "`', � <br /> Z ;ti����<.,�, �Q <br /> iJ��� c.,��r �.'�;F �N �a�=m�T l���n �� <br /> STORIES: SQ.F�ET OF EAC�i FLOOR: • <br /> �� <br /> NO. QF B�D�tOOMS: GARAGE STALLS: ATT. DET. <br /> i � ,<<i� <br /> EST�TED CC)NSTRUCTION VALYJATION (excluding land): $ �2-1 i�-E'�5 <br /> I h�reby apply for a builfling permit and I acknowledge that the infozmation above is compleie and <br /> accura�e; tha�the work wi11 be in conformance with�he ordinan�es and codes of the Ciry and with <br /> the Srate B�tilding Code; that I understand this is not a permit and work is not to start vcrithout a <br /> penzlit; and that the work will be ' accordanc�with the approved plan. <br /> A.PF.'LICAI�T'S SYGNAT �:� _DATE: /0 3 6_ � —_ <br /> 1VOTE r P�r d�Q�F�'ome.,� events require separate permit approvul by Police Depa.rtment and <br /> Ciry Cou�tcil 60 days priar to the event. Non perntitted events will not be allowed. * <br />