Laserfiche WebLink
WHO MAY APPLY ? <br /> ONLY THE OWNER OF THE PROPERTY OR A LICENSED CONTRACTOR MAY TAKEOUT 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 and a worker's compensation <br /> • A completed and signed"Owner-Builder Verification"form insurance certification(this is not necessary if this information is <br /> • A completed"Authorization for Application"form if other than already on file with the Department) <br /> the owner applies • A waiver form if the contractor is not subject to worker's <br /> compensation laws <br /> • A completed "Authorized to Sign" form if other than the <br /> contractor applies (this is not necessary if this information is <br /> already on file with the Department) <br /> THIS PAGE TO BE FILLED OUT BY DEVELOPMENT SERVICES STAFF <br /> PROPERTY INFORMATION <br /> Job-Site Address: Tack ToA e APN: - Q -0 5L <br /> Cross-Street F Ile., n > Ci : T ZIP: <br /> Precise Location: qs- -p S R i o. <br /> P !�/ e S <br /> Subdivision Name: - Ma BI/Lot# <br /> Zoning and Setbacks Zone: -1(/0 Front O Left: d Right: /0 Rear: 1934 Height: — <br /> School District !tr Fire District: L -( - Li/ L <br /> Sewer District: P/Z/// Water District: AA to <br /> Approved Use: ra o/✓ / JAA <br /> Site Plan Type Hazardous Materials Survey Submitted:.Yes: No: ❑ <br /> MINOR:6 GENERAL:❑ MAJOR:❑ WA:❑ If answer is no-Please explain: <br /> Planning Project(SA, UP, MS etc.)Expiration date: ^ <br /> 6 /O _ <br /> MONTH DAY YEAR <br /> SPECIAL AREAS <br /> Subsidence Area:Yes: ❑ No: g Expansive Soil Area: Yes)4 No: ❑ <br /> Fire Hazard Area:Yes: No: ❑ Airport Zone: Yes: ❑ No-O(@ <br /> Ente rise Zone: Yes: ❑ N SJAFCA: Yes: ❑ No: <br /> aVy BUSINESS'LICENSE­" <br /> Required: Yes:'5K No: ❑ BL No.: _ Fee Paid: - Yes. ❑ No: <br /> COMMENTS t,lr <br /> - <br /> �� h 416/1 ,er)� IC <br /> 0900 5 <br /> Plan Check Only YES File# <br /> Technician: Date: <br /> F-BULDINGWRNDp11WER MAW-CCMMENUNL.D FIe W25 JRe*W 10.J 02) Page 2 of 5 <br />