HomeMy WebLinkAbout124769 WPMCITY OF GLENDALE I
BUILDING PERMIT , 0:' r;[7 INSPECTOR COPY
di Community Development Group f,1ti}+
5850 West Glendale Avenue
GLENE Glendale,Arizona 85301-2599
Office: (623)930-2800 Inspections: (623)915-3263 Permit No. 124769 Inspection Area: MH Issue Date: 03/24/2020
PROJECT INFORMATION Project No. Sq.Ft. Valuation
Property Location(Verify City and Zip Code mailing address with Postal Service) 768 1
5601 W MISSOURI AVE LOT 247 Permit Type
BS-DEMOLITION
Location Parcel Subdivision Lot# Issued By Statistical Code STD#
TIEFENTHALK 649
OWNER INFORMATION Sewer Elec Gas SRP Water Meter
Name: INVESTMENT BUILDERS LLC FF Cert Req
Address: 101 MAIN STREET#280 HUNTINGTON BEACH CA 92648
E-mail: kdh@investmentbuildersgroup.com
Daytime Ph(714)960-1923 Emergency/Fax# Mobile/Pager# Construction Type Occupancy Group
PRIME CONTRACTOR INFORMATION -�-� P. G'4- -`� EC
Name: OWNER-BUILDER a Li-4
('P
E-mail: -
Daytime Ph Emergency/Fax#
Contractor License No. License Type Salestax License No.
Description of Work/Special Conditions
BELAIRE MANOR MHC-DEMOLISH MOBILE HOME AND REMOVE IN DUMPSTERS. NO ELECTRIC,WATER OR II
SEWER CONNECTIONS REQUIRED. Inspector L. 1 . � —�/1
- �
DEMO PERMIT Date of Final G 26 Z.
Certificate of Occupancy Number
METER CLEARANCES INFORMATION
Electrical Date
Gas Date
I hereby certify that I am the owner or duly authorized owner's agent,that I have read this application and that all information is correct. I further certify that I have read, understand and will comply with
all the provisions outlined hereon. I also certify that the plot plan submitted is a complete and accurate plan showing any and all existing proposed structures on the subject property.
Signature Date
Provisions: The applicant is advised that issuance of this permit will not relieve responsibility of the owner or owner's agents to comply with the provisions of all laws and ordinances, including federal,
state and local jurisdictions,which regulate construction and performance of construction,or with any private deed restrictions. This permit becomes null and void if the construction work authorized is
not begun within 180 days from the date of issue or if at any time prior to final inspection and approval the work is suspended or abandoned for a period of 180 days.
RECEIVED
CITY OF GLENDALE FEB 0 7 2020
PLANNING&DEVEI OPMENT SERVICES
5850 W.GLENDALE AVE.,2ND FLOOR
GLENDALE,AZ 85301 DEVELOPMENT OWNER/BUILDER ADDENDUM
Glendale 623.930.2800 SFPVI(`F°
ARIZONA www.GlendaleAZ.com RESIDENTIAL PROJECTS ONLY
DATE: COG PERMIT NUMBER:
PROJECT NAME: PROJECT ADDRESS:
ecs, (ft, . 6Vf ) 1 ttQt I *--c9-147
The undersigned-applicant asserts that she or he is exempt from the original contractor licensing requirement of Arizona Revised Statutes Title 32,Chapter 10,
on the basis :
ARS 32-1121.A.5 The applicant owns the property and shall occupy the property,and does not intend the property to be for sale or rent,and shall
have the work performed by the applicant alone,or by the applicant with employees of the applicant,and/or performed by duly licensed
contractor(s)all of whom are identified below or on the attached.
L I ARS 32-1121.A.6 The applicant owns the property and shall have the work performed only by duly licensed contractor(s)all of whom are identified
below or on the attached.
CONTRACTOR/COMPANY NAME: AZ ROC NUMBER: LICENSE CLASSIFICATION:
❑ ARS 32-1121.A.7 The applicant is registered architect or engineer,or employee of registered architect or engineer engaged in professional
practice,not as a contractor.
The undersigned swears and affirms that the information herein is true and accurate,and acknowledges that the filing of an application containing false or
incorrect information with the intent to avoid licensing or tax requirements of the State of Arizona is"unsworn falsification",a criminal misdemeanor.
PRINTED NAME OF THE OWNER: SIGNATURE OF THE OWNER: DATE: