|
, No��-14�x001 09:52am From-CITY OF 4RON4 +g522494616 T-186 P.002/003 F-997
<br /> !
<br /> Total Fe�: $ � '�`� � �`� D�te Reeeived:
<br /> Entered By: --- - permit#: -,��-
<br /> �y�� `��� �.�
<br /> C��'Y O� 4R4N0� � PERMTI` AFFLICATYON
<br /> . All inform�tion must be suTomit�ed in Y'uIl before plan revi�ew will be started.
<br /> fplease print ull inforntutian)
<br /> _...__�..... ____---...___.--__—�, �.—�-------------�-- .
<br /> T�E Al'FLICAN'r' IS: (ctrcle one} OV[�YER QI� CO�'�'RAC�'OT2
<br /> JO� ST7'E AI3DRESS: , 33`/� � ;��.,�i� _,/�,z., _ ZIP: , S53`�/
<br /> 11YANi� UF OWNER. " ` PF�ONE: (h.ame}
<br /> �1 h" ��J�� ���•u
<br /> (Yvork) �>/ �/ar�
<br /> �IA�iNG A:DDRF,SS: �,4�°2�v .si���-n�r.�.'�,...�CYTY:_,�/,or�i , ZYP: 5539�
<br /> C41�iTRACTOIt: ��1�.� � E%�r.�-nrt��- PHUYE: fr��`i-�3Y- 7y�e
<br /> C4N''rAC'�`Y'ERSOI�:_Sc�rr ��srF-�,�,.,MOBIL�lPAG�ER: ��.x -Sff3 � i�/3�
<br /> MAQ.ING ADDRE�S:�-�� �.,,�t �r�rr,��.,_.,,�✓' --CITY':5r-��w�.y Z�['• S'�a :�.
<br /> STATE Y.ICFY�SE: � "'�''
<br /> A�CH[T�CTIEN'G��TEER: �:ro.s� sr�.cF:s PHOiV�: �1SZ-f� '��e�/
<br /> MAIY.ING ADDRESS• S�Sro7 �.✓, £3c� � s-r�CI'�`Y':�'�cx,�,�.✓E-,-�,:.� ZIP:��
<br /> 1VA1.!'IE:..t�'',�,�r� Yo.� _,�1t��iSTRATION� .
<br /> T'Yg� C�r'W4Rl�: New Addi+ion t�CC�SSC71�/ JCTLil:1.tSPG
<br /> Move ,� Remodel/Al�eration� i,and Aiiera�.�ii�, ___
<br /> �'RC?�C���i Wut'�"s�uescrwe iri cieiaii�:�.,.•,,,i� �•X�c.� ����.�5�'c�✓S A�.�
<br /> D?v,✓v�'►�� �9t�5 .9i✓. _ ��✓5�.9�tc. h��avA'1 [-c�u5 ,�.� ��fs, I�Es,r>,�J a4�oP�
<br /> yv}�y Jf.
<br /> 3T4RxES: ��. �x:i�t"3��t�t::x"�r�.�'uiasZ:
<br /> � NO. �JF B�D1��101VI�: � t�►ARA�G� SY'�.I..iS: �.i'• -- �ET. �
<br /> 4�
<br /> ESTIMA'Y'�D C(]NST�tUCTION vA:G'[JAT�:(7FV (exciuding iand�: $ lo,oz�"� _
<br /> I hereby apply f�r a b�tilding pemnit�rid I aclm��wledge that tlie �ormation anove is compie�c d.u�i
<br /> accurate; that th�worl�wi�l.tae in conformancc with the�rdinances anti codes o=us� i:iiy auf��vi�ti
<br /> th� State Suilc�in$ Cvde; thar 7 und�rstand thit, is not a pe�n.it and work is not to start wifhoui a
<br /> peTu:it; and that th� wqrk will be in accat �:e with th� &pproved plan.
<br /> AP'PLY�AN 1'S SIt��T,t�.T��;: r.�- �i��'E: I/- /5��
<br /> N'dTE! Par�de a,�H'�,mes events require separaPe p��m�t��prvval by Pol�� �?apurt�rr��.��
<br /> City Counci�60 davs prior to the event. Norr p�rmitted �r��ne� will noe be a1l�wed.
<br />
|