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From:ELDER JONES INC 952 854 4909 05I16I2007 11:10 #242 P.002I002 <br /> . . <br /> . � <br /> �� •�� /� i 1� <br /> Total Fee: $ Date Re�eived: ( �� <br /> Entered Sy: Permit#: <br /> CITY O��1201�'O-B�C7YLDING PERMIT APPLICATION <br /> All information muat be submitted in full before plan review wiXl be started. <br /> (please print all inforr,�ation) . <br /> THE APPLICANT IS: (c�rcle one) OWNER O CONTRACTO <br /> JOS STTE ADDRESS: 3�q i �.1 V l 11 Qi sy � Y� ZII': '�S 3 q � <br /> Will this be a Par$de of Homes,Remodelere S�owcase�ome or ot�er Display�ome? <br /> ❑Y89 Q^�O' Ifyes,a special event permi�is reguired with Police Department and City Counsil approval <br /> 60 daysprior to the event. Shuttle bus service wtll be requlred xnless applicanr dernonsrrares <br /> suffccient on�ite parking is avatlable. N'on permttted events wlll not be allowed <br /> NAM�OF OWNER: Va r a T t�Z G/ p�ONE: (�aome) q�a 1-0,3 a q <br /> �Wv��> <br /> MAII�ING ADDRESS: CITX: ZIP: <br /> CONT�.2ACTOR: T�D At-Home Services, Inc. p�0�: q,s� 5'-(,Ok7 <br /> CONTACT PERSON: Dba Tha 1Tome bepoc At-Home Services AGER: ,J ed� m �td r r Ja�S <br /> MAILINGADDRESS:— 3200 Cobb Galleria, Suite#200 .. �: <br /> STATE LICENSE: # ^ Atlanta, GA 30339 ,��T�: <br /> � License#20268257 -763-542-8826 <br /> ARCffiTECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: C�TY: 7�: <br /> NAME: REGISTRA'�'ION: # <br /> TYPE OF WORK: New Home Addition A.ccessory 5tzuctuz�e <br /> Move Home RemodeUAlteration(ie: Siding,Windows) �- <br /> Any earth movement may requi MCWD review and permite: <br /> PROPOSED WORK descr�be�e d ac��: 0 D RC(�1 ^1' � <br /> � � � 0•�• <br /> STORIES: SQ.FEET OF E.A,CH FLOOR: <br /> NO.OF BEDROOMS: G.AR.A►GE STALLS: ATTACHED DETACAED <br /> ESTIlVIATED CONSTRUC'�TON'�ALUATTON(exclading land): S L• R � � <br /> I hereby apply for a building pe�it and I ac�,owledge that the information above is complete and accurate; <br /> that the work will be in conforma.nce with the ordinances and codes of the Ciiy and with the Stata Bui�d'uag <br /> Code;that I understand this is not a perntit a�ad work is nvt to start withvut a permit;and that the work will be <br /> in accordance with the approved plan. <br /> /�AF'PY�TC.ANT'S SIGNATURE: ��' DATE: � �b' b7 <br /> 31 <br />