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WHO MAY APPLY? <br />ONLY THE OWNER OF THE PROPERTY OR A LICENSED CONTRACTOR MAY TAKE OUT BUILDING PERMITS. <br />Owner-Builder must submit the following with the application:Contractor must submit the following with the application: <br />•A property tax statement or a recorded deed.•Current license numbers. <br />•A completed and signed "Owner-Builder Verification"form.•A completed "Authorized to Sign"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). <br />THIS PAGE TO BE FILLED OUT BY DEVELOPMENT SERVICES STAFF <br />PROPERTY INFORMATION <br />Job-Site Address:I Q09 I F :iT f2-r 12JJ APN:2..()):r')70 -/9 <br />Cross-Street:~C0 r r o /+()It City:IZIPOj1J ZIP:q <;-]t~ <br />Precise Location:h o f +1 S"I "jo('n-f?cr /JZ....,...12--0 I"l/\r •i/nn +vwr <br />O\.cces:S'Y(),.,....A .tI.~.J-.h...~._1 (n,(.'-ee-J-w~r-f-,-.,+tv."r 0/-/-0"At •••J IJ ~Subdivision Name:.-Map#BI/Lot# <br />Zoning and Setbacks I Zone:Il;;..-~()I Front:':S(")Left:10 I RiQht:/{J Rear:J(j I Heiqht - <br />School District:j~}C~/OJ-\Fire District:12../~~ <br />Sewer District:YO./7!;c·Water District:i:1/, <br />Approved Use: <br />SPECIAL AREAS <br />Subsidence Area:Yes:0 No:"CK.Expansive Soil Area:Yes:0 No:':i!:l <br />Fire Hazard Area:Yes:0 NO:~'Airport Zone:Yes:0 No:~' <br />Planninq No:SJAFCA:Yes:0 No:~ <br />COMMENTS zavt::»: <br />drAa;; <br />1/1 ferJor re fkoole/-I",A os-p 1"11"'/1 -I-~It-h~/~O(;< <br />( <br />hod f rli?J.v .,h_-Jjroo~~"VM..-l--h~~l-Iv""/\.•..e <br />/J J /j 7 ~ <br />l??-I)/()Y);'S 7 <br />Plan Check On Iv ()YES -File#J <br />Technician:!l~Date:7/(Ef/07 <br />/I <br />F:'BUILDING~NOOVTS ARCHIVE PRIOR TO 2008'PERMIT APP •RESIDENTIAL File .122.doC <br />(Revised 2·29-1)8) <br />Page 2 of2