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. • � � � ��� Date Received; ;�� �,� r��.�"llL ��, �� . <br /> ' Total Fee: $ � <br /> , ,� , �z, Pecmit#: � ��� ��- v ?L;t��, <br /> Entered By: —�:..!�� �� � � <br /> . . ,���i. <br /> C�y Q�' Q�OI'�TO STJII.DING���T �LICATION <br /> All informadon m�st 6e naitted fn fl�1 before plan rcview wilt be startecl• <br /> ase prini adl i�fornuttior�)------..w---..�------------- -- <br /> ,�,� App�,YC�T y�� (circ oRe) 4V�NER OR CONTRACTOR <br /> ' - � ZIP: �.S r �o <br /> yOB 5I'I'E ADDRES5: . )� � . <br /> ;. L� . ���/ P'HONE: ome) _ �01 L�� <br /> NAME QF OWNER' (wor�) � • <br /> MA�'[.�iG ADDRFSS: � <br /> � �� � CTi'�': ZYP-��S�I�SI <br /> 1 <br /> CONTRACTOR: ��'�o�:PI�ONE: �5�� -� � - <br /> CONTA�T PERSON: i MO�ILE/F'AG�t: <br /> M�LIY,ING ADDRESS; , <br /> ►v�,�CITY• �C1:�2` �!'tJ�'S�%�lfi-�: 5 5 3� <br /> STATE LICENSE: # V <br /> �� P�iONE: <br /> ARG�Y'I'ECTIENGTN�ER: CITY: ZIP: <br /> � NiAII�ING ADDRESS: REGISTRATYON� <br /> NAME: -- - � <br /> a <br /> TYPE OF WORK: New � Addiiion Acccssary Suuctur� <br /> Movc R�ntodel/Alteration � I.and Aic�cration�, <br /> � � <br /> PROPOSED WORK(describe ;derai��� �U�►� o�� �1 k _� <br /> e c <br /> STORIES: S FEF�T OF FACH�LOOR: <br /> NO. OF BEDROOMS: � GARAGE S'�'ALLS: ATT. DET. <br /> �S�.�ViA.TED CONSTRUCT hN VALUATION (excludin�land): $_`1�,fas4 J�. <br /> I hereb a ly Par a building pe � �t aad Y acknnwled$e that the information�bov�is comple�e and <br /> Y PP <br /> accurete; that the wotic will bc conformanr�e with the ordina�cos and codes of thc Ciry�w� <br /> rh� State Building Codo; that I �����Sw°h�rhe��pplrov d plan.3S �t to star� wirhouc a <br /> petmit; and �ha[the work w�ll, � �n ac <br /> APpLICANT'S SYGNA <br /> `- � DATE: � �.�..,. <br /> � <br /> NOTE! P[�tad8 of HQ2t�6.4 8Y � �tq� SeP��e permu approval by Police Depanment and <br /> C�sy Cou�cil 60 days priar to e event. Nor�permiaed events will not 6e aAowed. <br /> � <br /> 4 <br /> � <br /> � <br /> � <br /> Z/Z a��d `Wdti9�i� ZO-9l-T�f , `•Z966568Z56 `•�31Zd ��8 �UaS <br />