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� <br /> r <br /> f i 1 e c o p y 8uiiding Permit Application ���� <br /> DE �11E _ <br /> Total Fee: $ D Date Received: "� � / <br /> Entered By: Reason /�.v Permit#: �- <br /> Y <br /> C - BUILDING RMIT APPLICATION <br /> Staff: D�te: � <br /> All informat on must e su mi e n ore plan review wilt be started. <br /> (please print all information) <br /> ----------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: � ; �J S S�e l�'�� � , 7�p; 5 S 3�j <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 Counci!approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> suff cient on-site parking is available. Non-permitted events will not be allowed. <br /> NAME OF OWNER:�y'��E �'�1L1 ltelz- �i�j'iV��(L�UP Z/ PHONE: (home) �SZ-ZS�'O(p �C� <br /> (work) <br /> MAILINGADDRESS: 2,f3� S�'I�'1J�1Y1 j�i^, CITY: 'Ir' ZIP: �s3� <br /> CONTRACTOR:T � �'S 1'�' � 4 . PHONE: (G�Z-7�S 'UZ(G�G <br /> CONTACT PERSON: � �I�11,2 MOBILE/PAGER: _�¢�F <br /> MaiLlrrc ann�ss: « ���;,� �1,,, CITY: Cl�rr.u��� ziP: �s 3� <br /> STATE LICENSE: #�`)��(���j�, 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 /> PROPOSED WORK(describe in detain:�� ���;y, ����.��-���_j>ec� <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ q ��(�,� <br /> I hereby apply for a buildin�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 work is ot t start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATU �Q DATE: � �"�7 <br /> 31 <br />