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��iii��y%9; 1�1:5i FA1 61234n�A1i4 Mi'NULTY C�j�iii�,�iii�� <br /> CiTY OF GRGNO � 612473D510 10/26l97 17:04 � :07/48 No:4S1 <br /> Tots�l Fee: $ � Date R�dGeivod: <br /> EnrerGd By: ,,� - ��_ �etmit A�: �'' <br /> •--� - , , <br /> CITX �l�' ORON� � $X7ILDJNC PEItMYT APX'LICATION <br /> A11 �nto�matloa must be s4bmltted ta h�A befar� pl�n r�view w!ll b� st�rted, <br /> (Pl�ease print a!I ir�or�natlo�) . <br /> _�..,,..��_..._,—.�.»..r..............�,_,,,_�_.._..� � <br /> 'TH� A,�PLiC -- �-�-,......_------- <br /> A1�iT' IS: (Cfscl� o�re) 4WNER �R C�N7'ItACTUR <br /> ,1�s s� A���Ss: Z �ZS o� S�c �r�a�.lr: j� �� <br /> N� QF ���:- A� ��, t�,� 1,�, . _ <br /> � �ox�. cho�� S �'3 �'� <br /> ��,n+��a��ss:2�7.5 �1�SL,��;,�crrY= �w�k o �_ �. � <br /> --- �-�3�► <br /> CdNT�tACTOA: �� v� ���+s f v���au PHQIYE: �� �—O�L� <br /> �iDNTA�CT P'�RSON: r.., +.1►� MQB�LE/FA('s�R; � � 1 S S <br /> MAI�.�l�i�AAARF�SS: ro 2 Sr.. CTTY: h� i S. 9.,'IPr�.S b � <br /> 9TA'�'��LICEi�isE: �__ 5 lo 0 <br /> ARCH�'�CT'/�NGIN��R:y. S Lr�r�,a P���: ��'�--�� t 4 <br /> 11�AEx.�IVG ADDR�,SS: . ���CI1'Y: S �; <br /> NAM�: V. f. 1►�a► ��LS'TRAT�ON� • <br /> TYPE �F WQRKe N�w �Addit��x Acoesso�r Suu�ture <br /> . Move----- �Remod�UAlt�eration� � Att�ration <br /> rxo�wa�c��sc��►��r��: ;�-��, ,� ��1.� ;�.� a�.,�,,P #�,,.�,� <br /> � <br /> �R�+S: SQ. b'�ET Ol�'EACI���.00R: <br /> N�. �F $ED�Q�MS: �� CARAG� STALl.S: AZ'?'. DE1`. <br /> �ST11VtATED C4N.5'TRUG"1'I�N�AI.UATION(adudtn�Isad): � �t'�� . ��] <br /> I horeby Apply �or a buildi�g permit �d I�c�wledga tbat t1�e infarn�ation above ia complat�and <br /> �cCau'ate; th�t tt�e work wyll be in cdnfot�ma�e with t6e ordinar�rea and cod�s of the City and with <br /> the 3t�r,t� Building Code; that I u„dersuu�d rhie i� �ot a permic arid wark �.s not tu atart witlioui a <br /> permit: xnd thst the wprk wiil bc in �cor�� with the approved plan. . <br /> APPLxCANT'S SIGNATURE_ ��► � v� DATE: � O��� <br /> NOTEt �ve�et�r rsq�e sepau�ta panreft appravo!bj► pol�co Drpac�ent a,�d <br /> G�fy CtlunC�l i�daya pr�r t0 �ee dvelu. IVo►t per�t�ttd ever�t� w�ll,ep�be auoWed. <br /> s <br />