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ONLY THE OWNER OF THE PROPERTY OR A LICENSED CONTRACTOR MAY TAKE OUT BUILDING PERMITS. <br /> Owner-Builder must submit the fallowing with the application: Contractor must submit the following with the application: <br /> • A property tax statementbr a recorded deed. . Current license numbers. <br /> • A completed and signed"Owner-Builder Verification"form. • A completed"Authorized to Sion"form if other.than the <br /> • A completed"Authorization for Application"form if other than contractor applies(this is not necessary if this information is <br /> the owner applies. already on file with the Department)e <br /> � TOAG N ,SE29CES.STAFFTn0 <br /> g <br /> PG�300 P� 1�INFORM . <br /> r. <br /> Job-Site Address: APN:AL3 -DO - ZZ <br /> Cross Street: '} Ci ZIP: <br /> Precise Location: irpr <br /> "Am <br /> rZonnigisair <br /> on Name: Me BI/Lot# <br /> d Setbacks Zone: > �" D Front: Left: (} Ri ht: SCS Rear: <br /> School District: 4001 1,�dt o_ <br /> Fire District: <br /> Sewer District: Water District: i <br /> A22roved Use: J <br /> IR ..—.—����_.'�� <br /> CIAL ARL--����,7.J <br /> Subsidence Area:Yes: ❑ No: Ek ansive Soil Area: Yes:, No: ❑ <br /> Fire Hazard Area:Yes: No.: O Ai ort Zone: Yes: O. No: " <br /> Plannin No: SJAFCA:_... Yes: ❑.._. No:. <br /> 61 <br /> ® � 'I/ l� <br /> w� C_ <br /> 0OL,� � <br /> 001 1110,111111, P <br /> TajeDl-r VJ i c P <br /> `�Z r `# <br /> Plan Check Only YES Lf EFile# <br /> Technician: -7 6 <br /> Date: <br /> FABullding\Handouts\PERM1T APP–Residential.doc File#122(Revised 10-30.02) Page 2 of 2 <br />