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� + <br /> Building Permit Application �=��� <br /> DENIED <br /> Total Fee: $ � ��� Date Received: ��-3��0 ? <br /> Entered By: . . ��Permit#: 9/ / L�(�� <br /> , <br /> °."� �,� -a � �, � <br /> CI - IT APPLICATION <br /> Staff: Date: '�� <br /> All information must be submitted in full before plan review will be started. <br /> (p[ease print all information) <br /> ------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: � � �� � �;n q�fBs, �lq�, ZIP: 5S 3 s G <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes � NO If yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates <br /> sz�cient on-site parking is available. Non-permitted events 1vi!!not be allotived. <br /> NAME OF OWNER: ��r'L�a�of �1 a 9 e PHONE: (home) `7�.2 - `173 - I y 7 7 <br /> «<� <br /> �3r��t �) G�2 - q/G - � 2 `7 / <br /> MAILING ADDRESS: sti�+c �r /�bo✓� CITY: dro�o ZIP: �G <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER:.Spzc.�o� � „�.��,�,,.,,��f� �r��HONE: Gll ' 33� - 28Yy <br /> MAILING ADDRESS: (,Uo rv w.,s�,�..,�.., �„��°'CITY: �i,�,,,�yo,��. ZIP: Ssyo I <br /> NAME: _ � a l Lc�.ro/o�,J t REGISTRATION: # 7 S.):S <br /> TYPE OF WORK: New Home Addition Accessory Structure � <br /> Move Home Remodel/Alteration (ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describein detai�: �oo / a„o/ 3 scesa� aoo/tio�Te . <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �G O� o00 — <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the Ciry and with the State Building <br /> Code;that I understand this is not a permit and work is not start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: �� <br /> 31 <br />