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� <br /> � Total Fee: $ �,�l-�'` �� -'� Date Received: `i�-/�- �'� <br /> Entered By: /��� Permit#: � � �(��'� <br /> ,;`i/Y�'c" - ' �///7��-( <br /> CITY OF �RONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) � <br /> ._.___. <br /> �----- <br /> ------------------------------------------------------------------------ ===---------------- -- <br /> ---------------------- <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTO <br /> JOB SITE ADDRESS: �� � � ,.S ��U�►2- V l Gw �-. ZIP: � � 3 S �' <br /> NAME OF OWNER: �(L���s �2��r-�'��� PHONE: (home) 9J �— �7�� � v2 <br /> (work) � 1�.-��.�2 - 7 �7 <br /> MAILING ADDRESS: 5 n� � � ► � �}W� .S . CITY: �/� �- � ZIP: S j�l7 <br /> � 6rz. <br /> CONTRACTOR: � � � ✓��—�'�°7��I w�'' -�-►~'�- _ PHONE: �2�-—b�l �`7 <br /> CONTACT PERSON: lm u F'� �i�.=�L MOBIL AGER• 6 I�.-7��_ $y�S � <br /> MAILING ADDRESS: SG 2 i ( � j�-{ ,�}�..� S CITY: �,�,�I,S ZIP: ��� <br /> STATE LICENSE: # ��'� �-1 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME; REGISTRATION# <br /> TYPE OF W012K: New Addition Accessory Structure <br /> Move Remodel/Alteration ✓ Land Alteration <br /> PR POSED WORK(describe in detai�: i E/�,� �p wN c�" /�-�c a��`�� G�(m.ti6�'1. <br /> ;=r�o;�r-�-s �k) N��u S r l s �w Gy �I r�S Q � �.� i uc C s SP�+.,��.�.�J <br /> STORIES: �- '� SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> c:J <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � 3 � � - <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the Ciry 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: DATE: �l �}P(L<<-- p � � <br /> �. <br /> NOTE! Parade of Homes events require separate perntit approval by Police Department arcd <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />