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��� <br /> . �„\ o � <br /> Total Fee: $ •�G���i'- a`� Date Received: <br /> Entered By: Permit#• �'� �_ <br /> ,ry���/3/ec� <br /> CITY OF O�t�NCi - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: .:'-7 �� ��i L_���� �'� �' �k;zir: ��-, LJ�: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ NO ]f yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> su�cient on-site parking is available. Non permitted events will not be allowed. <br /> �Cti�b a��l Gt � <br /> NAME OF OWNER: C�%L%,t� ��/�`� W�� l �I���PHONE: (home)�;��- �t%`�'-��%(� <br /> (work)�;1�-7�=f I�-����C <br /> MAILING ADDRESS: .�`1�5`��i u�Kv���,.: t7� CITY: �7��;�:L� ZIP: `��":3��C.� <br /> CONTRACTOR: �;i����-� c-�,a�,z ��c ru_C�-� ��°�-pxo�: `I`�-�-�l��.-�iy� <br /> CONTACT PERSON: ����-�; ;�:%�--{�:�v MOBILE/PAGER: (�t':�-�{7�-���-3 <br /> MAILINGADDRESS:<�3'3� -�� �-',,�„c���i� �-�� CITY: !`'1��'Nh ZIP: ��3[F��-�'' <br /> STATE LICENSE: # :�d t C��:;t���'�, EXPIRATION DATE: �V� <br /> ARCHITECT/ENGINEER: �LCiv 1��'` Ut:t'�`�i�t� PHONE: ��:� -��-�i•-�'�'�:� <br /> MAILINGADDRESS: r.v;;i '�M���Ntti,'E 5 CITY: ���-{�F-F.��t� ZIP: -,��23 <br /> NAME: C�'N1� w iS�r(>-�--i7►=5'�v►�.� 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: �.i TG•�-1 i�IV �3�:;V�1-' ���;�: ;v i��� <br /> _1,1,'t 1�1�����-- � 'i%c�.K 4- �:,=:i;� ��f--'�j_—`� <br /> !�-Ift 1 N ��c^e���--j j v� <br /> STORIES: `''�'-' SQ.FEET OF EACH FLOOR:��C?�i�l���`G'(-' "J3=�--Ci i C=1�r��-7��� <br /> NO. OF BEDROOMS: `-;''L GARAGE STALLS: ATTACHED_� DETACHED_ <br /> E-� <br /> ESTIMATED CONSTRUCTION VALUATION(ezcluding land): $ %'�?�L% ,�/G't-% `� <br /> I hereby apply for a building 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 not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> , . <br /> APPLICANT'S SIGNATURE: ���- �w--����7/�-G�--� DATE: ����`- �3� <br /> , <br /> 31 <br />