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Aug, 31. 2006 2:49PM Elder Jones Permitting ���e 95No. 7286'`� -P._ 2�0 <br /> . <br /> � <br /> �� �S, <br /> Total Fee: $ DateReceived: `�"�'"�� <br /> Entered By: / Permit#• � , �, �.��(� � <br /> -�-�T <br /> Cl'I`Y OF ORQ�TO�—BUII�DIN�PE�.tMIT APPLICATIOl� <br /> All informat�on must be submitted in fn�l before plan review will be started. <br /> (please print ald infor»wtion) <br /> '1'HE APPLICANT YS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS: � (o O �►�t IU rU aaht�ZIP: S-S 3 q / � <br /> Will this be a Parade of Homes,Remodeler� wca ome or other Display T�ome? <br /> ❑Yes NO ,(�'yes, a special eve mit is requlred w'th r artment and Clty Counci!approval � <br /> 60 dayspTt event. Shutfle bus servtce w�e e��unless appTicanr demonrbdJes <br /> " r on-stte porking is available. Non-perrni ed�evenfs wil!nor be allowed <br /> � NAME OF OWNER: _�l�(� E5?aG LE'�` PHONE: (home) St 76-�/73 <br /> �/ (v�rork) Z -.36 S� <br /> MAILING ADDIZESS: a s�o ar,r�r w�v crrY: �N a z�: � <br /> CO�IT'RACTOR• T�At-Home Services, Inc, pHO�. � s_�o�� <br /> CONTAC',�PERSON: Dba The Home bepot At-Home Services AG�. ' � 5 <br /> —� 3200 Cobb Galleria, Suite#200 , � <br /> MAILXNGADIIRESS: _ ���� GA30339 �' <br /> STATE LICENSE: #_ Licepse#20268257-763-542-8826 DA'TE' <br /> ARCffiTECT/ENGINEER: PHONE: <br /> NIAI�iNG ADDRESS• �y� 7�p. <br /> N�' REGISTRATION: # <br /> TYPE OF WORK: Ne�uv Home Addxtion Accessory Structtue <br /> Move Home RemodeUAlteration(ie:Sidxmg,;WjadQ.�rs) cr--� � <br /> Any earth movement may raquir� MCWD review and permits! <br /> PROPOS VVORK(d scr�be in detaa�: <br /> STORIES: 5Q.�EET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STATrL5: ATTACHED DETACHED <br /> ESTIMATED CONSTRUC'TION VALUATION(e�cluding land): $ �d"a�- <br /> � <br /> I hereby apply for a building permit and X acl�owledge that the in�oraiation above is complete and accurate; <br /> that the work wi.l1 be in conformance with the ordinances and codes of tho City and with the State Bui,�din,g <br /> Code;that I understand tbis is not a pernzit and work is mot'to start without a permit;an,d Ll�at the work wiIl be <br /> in accordance rvith the approved p1an. <br /> AY'PLICANT'S SZG�iATURE: ��� � , DATE: � .� <br /> 31 <br />