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-. _ , ri (� �c�� ,� Sd-� � � �� <br /> � <br /> Total Fee: $ ,� � Date Received: �� o� �d/ <br /> Entered By: Permit#: � �/ <br /> - �� <br /> CITY OF�(�Nl O - B � v y��� <br /> G rERNIIT APrLICATION <br /> ' � �";�� ���;, ; ,-�,,��_: `; <br /> All informati� must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ------------------------- ----------------------------------.--------------------------------------- --------------- <br /> THE APPLICANT (circle one) OWNE R CONTRACTOR <br /> t =;/ - / / -� - � ? _ �� , -� .i r <br /> � ��/ - �� � �"�� �i � !�. <br /> ,;� �� JOB SITE SS:s.�2 'l��j' c��a�F'L-L ,�c�f'%2cf ZIP: <br /> ��, :,,�` <br /> NAME OF OWNER: ��,c-�/' O �g/�'r'/,c,�=.ot PHO • (hom�� �'s�-- �7' �-�� <br /> (work jS a'`� �.��� <br /> MAILING ADDRESS:;��.s�j ��c,17Y7` c,�CITY: (..,=�C C��P/d�ZIP: �-� <br /> CONTRACTOR: pNE: <br /> CONTACT PERSON: BILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAII.ING ADDRESS: CITY: ZIP: <br /> NAIVIE: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: ,�'.�,gy,1'� oiv ��' �i�,ze��U�2 /�,¢2�irv(r t���c� <br /> cr�n �� �<-�T �TU �n/`�-l/!/%�/it!' � �� � ���,� � .�r��-��T�--�o���. <br /> STORIES: SQ. FEET OF EACH R: <br /> NO. OF BEDROOMS: G TALLS: ATT. DET. <br /> ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ • <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> ; � <br /> APPLICANT'S SIGNATURE: ' � � DATE: /'� � 6� <br /> NOTE! Parade of Homes event require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />