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1 ; � <br /> CITY OF CRC270 - BJILDI�IG FER:�IT APPLICATIGN <br /> ^'otal Fee: $ <br /> �C/��� / �y Date Received: <br /> Date F��nrocec: <br /> cr nV: <br /> ��t�_e Pe�it�: <br /> :I..L INFOKI�iATION MIIST BE SIIBMITTED IN FIILL BEFOR.E PI�N REVIEW WILI� BB STARTED <br /> (See Chec?c-aff List Enclosed) <br /> --------------------------------------------- <br /> BE APPI,ICANT IS: (circle one ) O�tl.IER or CONT�ACmOR <br /> � .�r zzP: �S3 S�. <br /> �oa sz� x��xBss: f/�D �o,� r/�i�'C� �0,�9,� <br /> (work) <br /> /' � � <br /> .�ME OF OWNF.R: v� s��.�� /y������5�'^' PHONE: (home) <br /> _�.AILING ADDRESS: ! �,�-Id /�'7� ,/�Id��/L� � CITY= (�'��.N G ZIP: S J 3.5 � <br /> �ONTRACTCR: J (DO��TU� �'�-'v7r+��)�Y�)aaC PHONE: y%�J ��-%�3 <br /> ti:AII,ING �D�ss: ��v ;��Jzi�,���-�:c, cz�: �,til �,�ci� zzP: .S�r�S�� <br /> �TATE LIC�`7SE: � <br /> �CHITECT/ENGINEER: P$��' <br /> `AIZ.ING ADDRESS: CITY: ZIP: <br /> ;�: REGISTRATION T <br /> ,-vpE pg �ipRR- i7ew Additian Accessory St�ucture blove <br /> Demo R�*nodel/Alteration Renovate Land Alteraticn <br /> �soPos� wor�x (aescsibe in aetail) �����,J.�� /�,,�g,-�; ���,1�)v�,�� �v.�i �z--�-��^%� <br /> ,� 'l,,,�. <br /> STORIES: SQ. FEET OF EACH FI,OOR: <br /> �p_ pg gEDROOMS: G�RAGE STAI�I.S: ATT. DE'?'. <br /> �t� �. <..� <br /> '�T=Mp,TED CDNSTRIICTION VALIIATION (esc�uding Ia.nd) : S / 3 � <br /> = here�y apoly for a building per1nit and I ac?cr_c�r?edge that the information <br /> bove is comolete and accurate; that the work will be in conformance with the <br /> �rdinances and codes of the City and with the S�.ate Building Code; that I <br /> zderstand this is not a permit and work is not t� start without a permit; and <br /> zat the work wi11 be in accorda�.R'ce with he aporoved plan. � <br /> �/� g <br /> // !�� � DATE: � '"/ � -� <br /> ':PPLICANT' S SIGNATDRE: !i; . v, j� � <br /> i <br />