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Awl <br /> 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 necess ry 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: APN', <br /> Cross-Street: Q r Cit ZIP: <br /> Precise Location: a -S <br /> r.. AA^ ai <br /> Subdivision Name: - S Map# BI/Lot# <br /> i <br /> Zoning and Setbacks Zone: - Q 1 Front !f_ Left: Ri ht: Rear: b Height-.35 <br /> School District: � �[ Fire District: <br /> Sewer District: L I VA T ater District: <br /> Approved Use: t?!A/ 2122- <br /> SPECIAL AREAS <br /> Subsidence Area:Yes: ❑ No: --Expansive Soil Area: Yes: ❑ No: <br /> Fire Hazard Area: Yes. No: ❑ Airport Zone: Yes: No: ❑ <br /> Planning No: SJAFCA: Yes: ❑ No: ❑ <br /> COMMENTS <br /> 0 L1 <br /> 2 z-t/ � a eo�17 <br /> q2_, <br /> wQ = 130 <br /> lflm- <br /> s s. <br /> Plan Check Only YES File# <br /> Technician: Date: o <br /> F*iBuildinglHandouts\PERM1T APP-Reside tial.doc File It122(Revised 143402) Page 2 of 2 <br />