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S2017-0127 - Permit Application
2. DESCRIPTION OF WORK -,/tea ESTIMATED $ VALUATION 0q ©c--� v SWIMMING POOL ❑ SPA Pq, POOL FENCING ❑ DRAINAGE ❑ Check Appropriate box for Applicant 3. OWNER'S NAME LAST FIRST] 1 ADDRESS OWNER'S E-MAIL ADDRESS �'jcxr:/ ji✓`ac� C � S�o��`-@ ,S�jeG%/"Ccdt,f`�L'c��, CITY STATE ZIP PHONE NO. /C/e�1/j�or� cash G'�I 9,?ccz 9yj eve/ opoS' 4. ENGINEER'S NAME LAST FIRST LICENSE NO. ADDRESS ENGINEER'S E-MAIL ADDRESS 1A01 IV iuf/;19 CITY l�p�e� / STATE ZIP PHONE NO. - Cl1 9z96,7 2M C70 vo 0 11 5. CONTRACTOR'S NAME BUSINESS LICENSE STATE LICENSE <� �% 30,P19666No�o��'3 ? Class/ ADDRESS CONTRACTOR'S E-MAIL ADDRESS 3l ��a��"MG✓Z' �✓/%r/� ea/i�S'�i�Ur��clulf/rvc/fih.11ei CITY STATE ZIP PHONE N0. CE USE ONLY PERMIT NO. 6ZA�-- D) D-1--- PLAN CHECK NO. l 2- �I 261 POOL P/C FEE $�//,,7 DRAINAGE P/C FEE $ LV Forms\Pool spa appl (rev3-04).xls ',4e U \ i r k-7 4 SNv