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„-� �� �--- -� - � � � , �� ���� ..i ..�,���� ,o��i'ra'eu�u 1-4c� r.uuG/uuJ �'Sc I <br /> T . r L/� <br /> �'oral Fee: $ ��-7 Date Received: � --� z -v��� <br /> Entered By: �`zi� Permit#: A v z �3 S 9 ..�� <br /> ��'1'Y O�' OR�l�TO - 8����1($ PE�tli�'�' �P�CA�O�1 <br /> AIi iaaformation anust be s�butifted 'ua full be�o�re plare treview will be started. <br /> (please print all information) <br /> ..—��_�..__ � �� ��� _�_--------------- <br /> T'd�EE ,�P]Pg.gCAlY'g.'IS: (circle one) �WNER O 1�TT'R,�CTL?� <br /> ' ' f. <br /> _-� ;�,; <br /> �ros sg� ���ss: !� I�I�'-�-���n;�� "� �: �-��.��=`1I <br /> � , <br /> � ; <br /> S <br /> �^ � • / <br /> N�ME oF o6�N�l�. ( ,�� r� �? .` �':,; � �.,'�,�� ��7 P�oxE. (ho ��.o��.. �'��� ��'E�- <br /> ' �,� - (wQrl� <br /> f 6 <br /> 1v1A.1LIlV(�ADDR�SS: �� ���\�`��,,�-�;(�� �� Cd'�'Y: �;'\�ii�ll i.C��C� Z�1P; �� %% <br /> � - <br /> , � . <br /> eorr�,�aoa�: - 1 �l '�1�'�:� ��aorrE:�� , - ; �'L4.-�CL� <br /> CON'�AC�P�12SON: �-,�,t�J I���R'1�15 li�OBiLLE/.PAGER <br /> �[.nv�a���ss: � � � . � �� �'' �:� � Y �. - -'� . z�: .����;�7 <br /> STA'TE Z.,ICE�SE; #�cC 4 �i Y 1� . � � . <br /> �iRCffiTECTfENGI�R: ��ONE: <br /> � 1e�i�1[T.l(NG A���SS_ __�� .. ��: <br /> ld'AIVdE: �tEG][�S'�'.��']C�N� <br /> �'Y� O�' WO�i: New Add�tion Accessory Structure <br /> Move Remodel/Alteracion� Land Alteration <br /> P]l�OP05'E� O�(describe in de,�ain: ! • r� t�.� `�j���.i�� �L �(A'. � �r�� <br /> i �� �� 1 �"� � IR A �n I �Vti r � <br /> •I L <br /> STOI�]ES: �S�. &'EET OF EAC�I�'I.00�: <br /> . NO. O�' BEF)ROOMS: GA]R.�.G� ST�L'S: ATT. DET, <br /> F.S'i'71�1'AT � �G `�, <br /> �. .�]D CONS1'RUL'TION VAL�JATION(eaccla�c�ag lan�: $ �(�.,_.. ,,� ; <br /> I hereby apply for a building permi.t and I acT�ziowled�e that the information above is camplete aTid <br /> di:curatc; diat r��e wurk will br an conformance wich tI�ordinances and codes of[he Ciry at�d with <br /> the Sta.te Building Code; that I understand ' is no[ a permit az�d work is not to starc without a <br /> permit; and that the work will be ” accard c�w�h e approved plan. <br /> �. ,; n . <br /> r v <br /> ��a,gc��s s�G�a�E� �,l' ' � ''�i,�!_ �a�: /� � ��- � <br /> ,, ` _ _ <br /> � N'OTE! Para�g of�otnes events require separate permit approva!by PoTice Depa�nt and <br /> � City Council 60 days prinr to the event 1lTon permitted evercts will not be allowed. <br /> £/Z ' d £66ti' oN 0060-ti68 (Zl9) NW S�3N�IS30-� WdZZ � Z OOOZ ' ZZ ' ��d <br />