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- ' CITY OF CRC�70 - BJILDING FERciIT APPLIC�TION <br /> iotal. Fe�: $ Dat� Received: <br /> Date A�nrocec : <br /> �ntered Bv: <br /> Pennit ;�- <br /> ?�I.L INFORMATION MIIST BE SIIBMITTED IN FLTLI� BEFOR.E PI,AN RE�7IEY�7 WIIS BE STARTF.D <br /> (See Check-aff List Enclosed) � <br /> ---------------------------------------------- <br /> �E APPLICANT IS: (circl.e one ) 0��7�IER or CONTgACTOR <br /> c- ��� c� / <br /> JOB SITE ADDRSSS: -� � � � �' �✓� � � c. � ZIP: � <br /> (work) <br /> :7� OF OWNER: _J � �!1 -�� I� ,� S �� ✓� PHONE: (home) <br /> *iA2I,ING A.DDRESS: �� �'`/ C, L �'/'� ` �v�. C2TYs �-^'�=t � z �; '� � ZIP: � �,�j / <br /> �� � �, C �-���, �?,�,���, pHo�: � �� �- �z �`� <br /> CONTRACTOR: �' ` S �-. �v✓� 5 �r c v'� <br /> " L � � < CITY: �"``°� �z `� � zSP: S� 3 "t f <br /> �..AILING ADDRESS: � SC`�� y• .'� <br /> . <br /> STP,TE LICENSE: T ��� 7 l-S Z- <br /> c�iC2CHITECT/ENG2NEER: ��/� PHONE: �! <br /> '.KAII,ING A.DDRESS: CSTY: ZIP: <br /> NAME: REGISTRATION - <br /> TYPE OF WORR: �7ew Add�tian Accessory Struc�ure rlove <br /> Demo R�*nodel/Alteration .�_ Renovate Land Alteration <br /> P�OPOSED WORR (describe in detail) - /�� ti^'�a�� � �Si -S�{"`� ✓�� G �;��� i����.�' <br /> „ �, � �, - ��� l� ��� I1� .� � r��� �',�� �-� <br /> r � �c r I U � � �g' � � S �e � � �� <br /> STORIES: SQ. FEET OF EACH FI�OOR: <br /> NO_ OF BEDROOMS: G��R.AGE STALI.S: ATT. DET. � <br /> � � <br /> ggTIMP,TED CONSTRIICTION VALIIATZON (ezcluding Iand) : $ �� ��L`% --- <br /> = hereby appl.y for a building per?nit and I ac?cncw?edge that the infor:nation <br /> 3bove is complete and accurate; that the work will be in conforznance with the <br /> �rdinances and codes of the City and with the S�ate Building Code; that I <br /> understand this is not a permit and work is not te start without a permit; and <br /> �hat the work will be in accordance with the approved pian. � <br /> . � '� <br /> � � _ � Ic�— 1Z�� <br /> _ <br /> A.PPI,ICANT'S SIG�IATIIFtE: , �l<"" C� �``��� C�' . DATE: <br /> .-�, <br /> i _ � . . <br />