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Total Fee: $ � � � � • �_`� Date Received: ���� ����Z <br /> Entered By: ��_ Permit#: �==' 1 i I 1/c��l <br /> , ,`�' <br /> �,.;,,;;,�, /�/c� <br /> ) � <br /> CITY OF (�RONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please prirat all i�iforniation) <br /> ------------------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle o�ze) ( OWNER�UR CONTRACTOR <br /> __ __._ . <br /> JOB sITE a�n�ss: .'������ ShD����G�.- 1/1 v-� ziP: ���� / <br /> Will this be a P�rade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �No If yes, a special evertt permit is i�equiYed with Police Department arzcl City <br /> Couneil c�pproval 60 c�ays prior to tl7�e event. Non pern�zitted everats will not <br /> be allowed. <br /> _ �lz� ����- ��� <br /> NAME OF OWNER: ��-��V� ��'���t��� PHONE: (home) � _ <br /> p,� (work) C �� - � � �_ � Z <br /> MAILING ADDRESS: ���(�'� ���G}�--��� IO�' � CITY: ��'���(� ZIP: ��/ <br /> t.���,��I U��I"- �7 7�"� `7j�„'r i l�i✓ � � �%�� I"U� 1�.��,� ��> � Lrc e.,.0 � 37 Z I <br /> ��j� ,� A �� ,, ,; � ��v� �;�yl�,� ,r���j l_ <br /> CONTRACTOR: I���(�-W����� �G�'1 ,�� ����ON� ���- � _5 � <br /> 3S <br /> CONTACT PERSON: ✓�` ��! OYl MOBILE/PAGEI�: (:!°IZ� �7 ' � <br /> Ma1LINc ann�ss: � ��� �,�� s�h�1 -h 11 ciTy: �� �i���.-� zlr: %� <br /> STATE LICENSE: # ��S ,;�� , ,�,� '�, � � <br /> ARCHITECT/ENGINEER: ' �J � ✓�G��1.��PHONE• <br /> MAILING ADDRESS: 5 {� ITY: /n> ZIP: �� <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Accessory Structure <br /> Addition Move <br /> Remodel/Alteration � Land Alteration <br /> PROPOSED WORK(describe iiz detai�: {���� �'L� l Gt�t,'✓� � �'i �� , �-� �j(,������ <br /> STORIES: -L . SQ. FEET OF EACH FLOOR: C� �'��� u <br /> NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $�.�9� � �(� �> <br /> I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate;that the <br /> work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and that the work will be in accordance with <br /> the approved plan. /, <br /> , �' <br /> APPLICANT'S SIGNATURE. ��'(/�c ( �G�� DATE: �� � �7` <br /> U <br />