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Frrna:ELDER JONES INC 952 854 4909 05I23I2007 15:30 #279 P.002I003 <br /> �- <br /> Total Fee: $_..C�� . `�� Dste Rec�ved: � �`��� <br /> Li:tL'L�iE B�: �J . �6�It�. �,(.....��,.�,L..�1� <br /> CITY OT' OR011�0-BUILDING PEltMIT APPLICATION <br /> All lnformatfon must be subm�tted in�a�befo�re plam review wiU be atarted. � <br /> (plea�e print all inforr�a�lio�,) <br /> • 'TH'E APPLICANr IS: (ctrcle o�te) OW�lER OR�ONTRACTO <br /> ���� <br /> aoB srr$�,nnx�ss: 3G q � L v r� � �I-v� r.�oP: �s34 / . <br /> Will this be a Parade oiSomes,Remodele�3ho�cvcase 8onae or other Display Home? <br /> • ❑Yes ❑No Ifyas,a sp�rfal�v��r per»ilt is rsqu3sed with Police,Daparr�nanr and Ciry Coa�etl approval <br /> 60 days prror ta!hs svent. Shuftls brts servtce wlll be required�tnle.rs c�licont demonsbates <br /> y�ictent on�s'ite,parJEin,�is availub[s. Non-pssmined eventr wd[t not be alfowed <br /> NAME OF OWNER �.��r c�n e �o�: m�o�y�i- a��s <br /> � c� <br /> MAn.nvGADDRESS: �l.q � Lv r�� A�v�crrY: t�'ova rnc �: S�3ql <br /> corrrR.a,c�ron: � r�At-xome s�s, �. ;rgo�: S 4 S- 0�7 <br /> CONTACTPF.itSON: _ Dba The Homb Depot At Home Senrices AGER: ��d• ;�r�i�� Jone s <br /> , 3200 Cvbb C3allcria, Suitc#200 . <br /> MAILIl�TG ADb�,tF,SS. _ A���G.A�30339 � �' <br /> 3TATE LICFNS�: # License#20268257-763-542-8826 .DATE: <br /> ARC�TECT/ENGIl�ER .. I n PHONE: <br /> MAILING ADD1tE5S: CTIY: ZII': <br /> NAlV�• RBGISTRATION: # <br /> TYPE OF WORK: Ncvr�Yomc Addition Acocssory3truciuro <br /> 1Vlove Home Re�oc�odeUAlt�ratioa(ie: Sidiag,Windows) �-- . <br /> Aay earZh movemena may requ re MCVPD raview ana pe�``'iLal <br /> PROP03ED OR�(describe in detain: � �0 /O (�O v'�' f�.Q(�C.� �3!'� � <br /> YI <br /> STORITS� 3Q.FEET OF F�i,CS FLOOR: � <br /> NO.OF BEDROOMS: GAIZAGE lSTALLS: ATTACHED DETAC�XED <br /> ESTYMA,TED CONSTRUCTION'Y,A�'UATTON(ezcludln�lsnd): S �+,3 0�� <br /> X hexeby apply for a buiidiag peraiit sad I acknowledge that the iaformstioa abovc is complete a:xd accurate; . <br /> that the woxk will be ia conformaace with the ordiaaaces sad codes of the City aad with t1�e Stabe Buildiag <br /> Code;tbat I understand this is not a pennit and wark ia not to start without a permit;and that the work will be <br /> in accordance with the appzoved plan. <br /> yAPPI.ICANT'3 3IGNATCntE:---�� D,A,TE: 5 3 d ' <br /> 31 <br />