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� <br /> ' CITY OF CRC2.0 - BJILDING FER:�ST APPLIG�TION <br /> t �� <br /> 'otal. Fe�: $ 1� � � `� Bate Received: <br /> Date A�nro�ec: <br /> '-.1te?"2� B�: Pe�-mit �: � �`0 <br /> 'xI.L INFORI�iAT10N MIIST BE SDBMITTED IN FDLL BEFORE PIu'�N REVIEW WILI+ B$ STARTED <br /> (See Check-aff List Enclosed) <br /> -------------------------------- <br /> ------ ---r--�=�_------------------------- <br /> `'°'3E APPLICANT IS: (circle one ) 0��1ER CONTRACTOR <br /> � � � <br /> �OB SITE ADDRBSS: � 7 S� ����v, C%L��+�; i��k ��% ZIP: <br /> (wark) <br /> '�AMI: OF OWNER: � 6�7`�'�', (��`l2��� , �, I PHONE: (hcme) <br /> /� c' <br /> '�+AII,ING ADDRESS: �,� � (- `"''�'����� �G-��- CITY: �i �'� �i'Z�1 ZIP: � <br /> � ..� PHONE: S� � ._ �> t> <( 7 <br /> �ONTItAC�'CR: (�f' c,�c c' L't'( � _ � <br /> uAII,ING ADDRESS - �W �� � ` �vl��'t c r� L �i�� CITY: �c, ZIP: ���-/ � <br /> / :� <br /> STATE LIC�:`7SE: ' U`O�� (�� �� ( � <br /> :�CHITECT/ENGINEER: Pg�� <br /> ��:AILING ADDR.ESS: CSTY: ZIP: <br /> ��E_ REGIST?�TION � <br /> '�"rPE OF WORR: t7ew Addi�ion Accessory Structure rlove <br /> Demo R�*nodel/Alterat�on_� Renovate Land Alteration <br /> ?�?OPOSED WORR (describe in detail) - P a^�'i2 �' /?�u i `�� <br /> '� �r � �� � ,/�, , � "� �'/ ��-z- � ,S ;Q /�z C� <br />_ / <br /> STORSESs � SQ. FEET OF EAC3 FI,OOR- <br />�Q_ pg BEDROOMS: G�RAGE STALI�S: ATT. DET. <br /> :��- <br /> T_:STIMATED CONSTRIICTION VALIIATSON (ezcluding Iand) : $ � � / � � ' <br />� hereby apoly for a buil.ding per.nit and I acknc+�ledge that the infor:nation <br /> _bove is complete and accurate; that the work will be in conformance with t�e <br /> -rdinances and codes of the City and with the S�ate Building Code; that I <br /> _nderstand this �s not a per:n=t and work i not to start without a per:nit; and <br />=hat the wor'� will be�rdance with t aporov a�• � <br /> AppI,ICANT'S SIG:`7AZ'IIRE: - <br /> \ DATE:%G' �/ Z'�. <br />