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AUG-08-:00 02 :37 PM P. 02 <br /> � 1_—. <br /> a��-�4-to�c i�:ter� �ram-�iTY o► o�ono +I�t2G9a0+.d r-,ei F Ob�JE06 F-E32 <br /> Tacal Fee; $_��._ uace xcce�vea <br /> Entcred Hy: � .. _.. , ���� Permlt,�: 'e <br /> CIT� OF ORUN4 • AYTILDLVG PERMTr 11P1'LICATI()N . <br /> Al! information tau�t be submitted in f�11 beture �lan re�iew wi1l be started. <br /> (pfease pnra all fnfornu�rton) <br /> THE APPLICAN'T.IS; (ctrcle one ~OWNFR OR CONTRACTOR <br /> ��._�_ <br /> JOHSYTE ,�1)PRFSS: �.at / /.�t��l�`l ��':-� l��il_�- ZIP� <br /> a�.-r ���7 ,,4 <br /> ^ ' � ` S <br /> NA�viE OF OWl`"FR: T�2�c�'_, :.�..�'�� '4. � +� PIIONE: (homc) �� 2 c, � S - Y I -. <br /> (work} (�/�.��! �O��rQ' <br /> �IAII�ING ADDR�SS: � 6� � r r • �c/_. . .CITY: � 2�P: <,-S tI��',� <br /> [�k,w ��a¢�Id� ,�e,�uv .l�,ktis�.�.ti ; <br /> tu'1{�c.CfacJ ��t fi� c'�..nr.ia�rr�lr. <br /> CON1'RACTOR: St��� � �,, z d PHON�: �_.. . . . ......_ <br /> CONTAC7�RSON: - MOBA.EIPAG�:�t: . _ <br /> '.viA1]aING ADDRESS: CYT'Y: ZTP: � <br /> STATE LLCENSE: �l <br /> ARC EXIT�CT/Fl\GIlVE�R: P�T�h'E; <br /> NtATLIl'�'G�ibDRE3S: C!'rY: �� ._ ... <br /> NAME: .._..._._ REG131`RATION� , <br /> TYFE OF W'UR.K: Nctiv Addiqan Acces�ary 5Lrua��re _,_,� <br /> Mo�e Rernodel/Alcaracion_ Laa�i Alteraa�n r„�_ <br /> ��-- � � <br /> PROP09F.D W��K (descNbe�n detai�: �' �- `�' �� ��!`'.�`'�� <br /> STOItIES: _ SQ. F�ET OF EACY�FL04R:_,____��..�____�- <br /> NO. OI'BEDltU01�iS: GAf�AGE STA,LLS. ATT� D�T.---_ <br /> ESTLViATFD CONSTRLC'r10N VAL[;A'fION (excl�d�.n�13nd): S .,�...,� <br /> C bereby apply tor a building pecu�it an�t r acknowlalgc that the infarmauon abo�e is complCco sud <br /> accurate; thai the worti wi71 be in�ro c with the oediflaacas aad eodes of�fia Ciry �d aEth <br /> cbe State Building Code; thac 1 u ers 1 �tus is aot a prrm.i�and work is not co ataR'�ichouc a <br /> permit; end that the work vs►ill ba'�iri acc rdasue with[he approv�d plan. <br /> , '� � <br /> aPALICAN'T'S SiGNATYTRE: ` '�'� r „� naTE: � � � v U <br /> lYOTE! pa�ade of Homes events reQuire �eparate Pe��t�FPr°�al by Pulir� Depurtmen!and <br /> C,`uy Cauncil 60 days prtar ro the eve►�t. Non perrnitted ave�ts will nat b� alluwed. <br />