Laserfiche WebLink
:�� ,� __ �, <br /> Total Fee: $ �-- � �-'� f � y DateReceived: 2-Z3-O� <br /> E�tered$y: �� Permit#: �1�72�f g <br /> r'J�v1 ,_, -- ���`��L�� <br /> CITY O�ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ------------------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: 2-F����' ��'���� G��/• ZIP: ��3�%/ <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ No If yes, a special event permit is reqi�ired with Police Department ancl City <br /> Council approva160 days prior to the event. Non permitted events will not <br /> be allowed. <br /> NAME OF OWNER: T��'=� �°���'���r�� PHONE: (home) �/�—'�7 �`��'v�' �� <br /> ��� 7"�'�'.n.✓G��s_v,� (work) l��a � lr1�r—s��;� <br /> MAILING ADDRESS: CITY: �— ZIP: <br /> CONTRACTOR: �����Tt�f.�-�/ ��CC�',�-.�c� G'vy�r. i�G- PHONE• �(C��-7 �-� -t�c;�i'� <br /> CONTACT PERSON: �T�'tiy ���v�� MOBILE/PAGER: C�''�� ,3��'-' '�'��� <br /> MAILING ADDRESS: `�i�3�'3 '?�' �' ar: CITY: .�i�-:.-�.Y�'�zdy ZIP: �'S'��--� <br /> STATE LICENSE: # ��L 7� �3 <br /> ARCHITECT/ENGINEER: 2�-�'��c:.�� ���3��,�f.qr%�� PHONE• ���'�7 ���—9c'�"5'' <br /> MAILING ADDRESS: ���� .�ra-�;�-.tx�-- �r_ CITY: .�,n�-�. ZIP: r��� <br /> NAME: .�i� �- � REGISTRATION# <br /> TYPE OF WORK: New Accessory Structure <br /> Addition � Move <br /> RemodeUAlteration Land Alter��tion <br /> PROPOSED WORK(describe in detai�: ���►/i�f� u`���"'�-- ��'t�`t�- <br /> STORIES: � SQ. FEET OF EACH FLOOR: �`��� <br /> NO. OF BEDROOMS: GAR.AGE STALLS: ATT. DET. <br /> ESTIi�IATED CONSTRUCTION VALUATION (excluding land): g� ��'� �'E'`° <br /> I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate;that the <br /> work �vill be in conformance with the ordinances and codes of the City and w�ith the State Building Code; that I <br /> understand this is not a pemut and work is not to start without a pernut; and that the work will be in accordance with <br /> the approved plan. <br /> � d� <br /> APPLICANT'S SIGNATURE: DATE: z " �� `` <br />