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/ ti <br /> Tocal Fee, $ � �7 � � c' L�ate Received: �' _l� -C: 3 <br /> �nterad By: , �?_�� Pcrmit#: ri �� (,�i,- ��� - <br /> � ev�`x�; gf/�, <br /> � A CYZ'X OF (�1��N0 - �Y]II.,DING FFjRMI'� AP�I.YCATTON <br /> Al�inFor�at�on must be submitted�n full before plan re�ew wfU, be start�d. <br /> � (please print a11 info�ion) . <br /> _�_ .�. __,-.�-�___._�--- __-�.-.— �-----�.�-�----- . <br /> THE App�,ICA�tT YS: (circte one) 4W1VER O CON RACTO <br /> araa srr�aa�n�.gs: �sr ��n��. � �. � �; �5�1! <br /> NA1v� 4�'oWNER: /I/4nt �r � pII4NE: (h�e) 9��5�a�-O�g� <br /> AiAII�NG A,DDRF�,S; �3yS �,ti�•�� ���i �.__CTl"Yt{n o�o �II'=,�!s'?9/ <br /> corrr�.c�ro�c: ���,. t3�:lk�s, �� _ pHa�: ��� y�-9 3�0 <br /> C4NTACT P'F�tSON:,_(�.-c..,,�� MU�IY�E/PACrFR: f,�a�OS�91 � <br /> MAII�Il'�TGA�DR�E38: �d� G,�,�.- �� +�ot,�. CTl`X: ��vc•� Z�':.�S.�LS� <br /> STATE L�CF•I�SE; # �0�',�o��j 7 <br /> ARCI�TECT/FNGINEER; P�O1V�: . <br /> 1VIAII,.]NG ADD1tFSS• -- CxTY' ZIP: � <br /> . ,.,. <br /> NA�1V�:� REGIS�T'ION# . <br /> T'YPE OF VVQR�: N�w A,ddicion Acaessory Stn�c�re _ <br /> Movz 12emodcllAlteration�� Land Alteratfon�, <br /> PROY'OSI�'.D W4R�(des�ribe fn derai�; , � ��,� I�G e����^,� ,,,>;����� - <br /> STOR�ES: S4.FEET UF EAC�I F�,QOR: —� <br /> � NO, OF BEDYt4C�MS: � GAYtAGE STAY.�S: ATT.. . DET. � �� <br /> , � <br /> EST�MEI.TED CUNS�RUCTIOTT VALUATIUN(e�cludi�tg lau�: $ �' ' <br /> Y tieereby apply fac a builcling paruiit and I acknowledge rhat tl�e informatian above is camplet,� and <br /> accurate; ihat the work will be in ca�ennanc�with the ordin�ces and c�des af ihe City aad w�h <br /> �he gt�te guiidi.ng Code; tl�t I understand this is t�t a permi�and work is uG�to staxt without a <br /> p�mit; and that the work will be in accordance with the approved plan. <br /> APPLICANT'S S�CYNATYIRE: DA.T�: / <br /> �0�� p���Qf em�s even#s requtre separate pefrr�it QpprQval by Folfce Departritent und <br /> Gtiy CounciX d0 days prior ta the event. Non•perm�tted events will not be allowed. <br /> ��z�d 9Z9b6bZZS6�01 �W0�1� d�b��Z �aOZ-Sti-Jfltl <br />