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Buil*ing Permit Application !� �'`� �� � <br /> - DENIED <br /> Total Fee: ` Date Received: 4 p <br /> Reason(s�t�{e�,��i�l• Permit#: 00 <br /> � � � � �f}�- �i - BUILDING PERMIT APPLICATION <br /> Staff: Date:—���� <br /> All information must be submitted in full before plan review will be started. <br /> (please print a[l information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: ��`"l S( S��./W o s � �� ZIP: <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 wil!be required unless applicant demonstrates <br /> su�cient on-site parking is available. Non permitted events will not be allowed. <br /> � <br /> NAME OF OWNER: � q.._�./ � d-�� ��� � '� PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: �a••-IL �. VJ�`\,�-w•S Cc�S}��� �"L PHONE: Co I� - �S I — °l7 S O <br /> CONTACT PERSON: �a�1� MOBILE/PAGER: <br /> MAILING ADDRESS: I va �„�P S� S��-- S�. �t CITY: C t��.j k� ZIP: S'S S t Fl <br /> STATE LICENSE: # �6''1 q �!�-(c� � EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <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 /> P,R�OPOSED WORK(describe in detai�: �o�o( o(o-+-,,,� ,,_ ,,A�_� f, �e, <br /> �"� � �� �� ��/ <br /> STORIES: �- SQ.FEET OF EACH FLOOR: ��� a <br /> NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED DETACHED� <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $�4c a G�' <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 City and with the State Building <br /> Code;that I understand this is not a permit and w is not to start wit out a permit;and that the work will be <br /> in accordance with the approved plan. � <br /> APPLICANT'S SIGNATURF� - ` - ' DATE: d'I�a���° � <br /> 31 <br />