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� <br /> � � c�.� <br /> Total Fee: $ �'�� �� �; _� Date Receive�i: � � �, C; �.... <br /> Entered By: �}y���n�— Permit #: ��' S��'o � <br /> ' • �l , � � i . -� �� ` �r'�� <br /> � c-�..- _ , . , <br /> : ���)-}�'.J � � r c. .�._ <br /> '�n � o � �.� CITY OF 0�2bN0 - BUILDING PERMIT APPLICATION <br /> ,� �� � �;,-. <br /> �� ,� <br /> �, <br /> (�,��'�' All information must be submitted in full before plan review will be �tarted. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER O ONTRACTOR • <br /> JOB SITE ADDRESS: I J�� ��� • � ZIP: 3� <br /> NAME OF OWNER: ��, PHONE: (home) '����J <br /> 450 (wor c) <br /> MAILING ADDRESS: CITY: ZIP: <br /> � NA 1�- 7 •581� �' <br /> CONTRACTOR: 1 �/'�GI�,�,I I PHONE: ' '�� � <br /> CONTACT PERSON: e MOBILE/PAGER: <br /> MAILING ADDRESS: �CITY: ZIP: ' <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: 1 • <br /> MAILING DDRESS. �,1r p CITY:�{�{ltS�j ZIP: <br /> NAME: ' � REGISTRATION# <br /> TYPE OF WORK: New� Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> P OPOSED WORK(describe in detai�: �♦4����'�� <br /> .� <br /> STORIES: • � SQ.FEET OF EACH FLOO • �� •�. 35O <br /> NM- '_/ <br /> NO. OF BEDROOMS: '� GARAGE STALLS: ATT. �_ DET. ��� �� <br /> ESTIMATED CONSTRUCTION ALUATI�ON(excluding land): $ .��,00� '��p�� <br /> °y�'iy�,o-�c , �,ap• p,�► � <br /> I hereby apply for a buildmg permit and I acknowledge that the information above is com lete and � <br /> P <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 /> APPLICANT'S SIGNATURE: �j�, DAT'E: ' ?/ <br /> NOTE! Parade of Homes events require eparate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 9 <br />