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'�. ���. ��; <br /> , �Jun--01-200�, 09:13�m From-CITY 0� ORO�C � . � +9522494616 T-152 P.002/003 F-235 <br /> Total Fee: $ Date Received: <br /> Entered �y: Pe�mit#: <br /> CYT'Y OF D�tO1V0 - BU�DTNG �ERMYT APPLICA�ION <br /> ��-( �.�-\ - <br /> �"' �,Q. AlI inFonanation must be subm.itted in full before pian re�iew vrill be started. <br /> `!"' (please print all information) <br /> -----------"---------------------�----�-------------------------______j..�-__�_�_`�_ . <br /> T�3E APPLYCANT IS: (circle one) OWNER CONTRAC"I'O'R '� <br /> � __._ ___ _...___.-�' <br /> JOB STTE ADri�SS: '���G� /��1 ���I�I'Yl��'� . ZIP: �����,��� <br /> N�iME ��' OWNER: � ':�.e' �:�-,/r;�: ����--,_,,�7�-�.�%<�� <br /> PHO?�IE: (home) s.,�' <br /> � � (�vork) <br /> NIAII.L�1G AnDRESS: �1�:-�-� CITX: ZIP: <br /> CON'I'RA.CTOR: J�Z�,-�� ` - �?�C'��i/✓PHO�TE: .'1��� -:���L%%lG <br /> CO�PTA,CT PERSOl�: '.� �' MOBT�EIPAGER: <br /> NZAILIN�ADDRESS: G7C� '-- � CI'i'Y: t�l��-�r :r% 7IP: ,h��� <br /> STATE LIC�NSE: �i �01 <br /> Al2CHI'T"ECT/ENCIIVEER: PHOti'E: <br /> MATT, 1NG ADDRESS: CITY: ZIP: <br /> N�,�; REGISTRATION# • <br /> T'YP� OF WORK: New Addicion Accessory S�ueture <br /> Move RemodeUAlterati�n Land Alteration <br /> P�20POSED WORK(describe in detain: :��'�� 1� � � � f��h-�'��� <br /> STO�tIES: SQ.FEET�F EACH�'I.00R: <br /> NO. OF BEI3ROOI�ZS: GARAGE STALLS: ATT: � DET. .. ._ . . <br /> �.ST�TED C4NSTRUCT�ON'V'AT.YTATION {exClUdi.na land): � � � I��• �� <br /> I hereby apply for a building permit and I ac�owledge that the information above is complete and <br /> accurace; that the work will be in conformance with the ordinances and codes of the City and with <br /> ihe State Building Code; that I understand this is not a permit and work is not to start withQut a <br /> permit; and that the work will be in accordance with the approved plan. <br /> APPLYCANT'S SYCrNATU�tE: �`���'��Y-'�/ AATE: /-"�'�'%,� <br /> �� �,�.� �'��-u�/ <br /> NO3"E.' ��f�o� events r rre separaie permtt approvaI by Palice Depar�tment and <br /> City Council 60 days prior to the event. 1Von permitted events wi�l not be allowed. <br /> l'�.' - f_ '-��c'C' <br /> , �1�� ��� � <br /> �� � `��`a ^�� ��� �� � <br /> � <br />