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JAN-24-2010 22:20 FROM:ESTHERS PERMITS 6513300894 TO:9522494616 P.1/2 <br /> Total Fee: $ 0. 1-5- Date Received: <br /> Entered By: Permit#: <br /> CITY OF Of .0 - 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 4OCONTRACTOR <br /> JOB SITE ADDRESS- , 377S S T o 9 c ii�„I 71P: <br /> Will this be a parade of Homes,Remodelers Showcase Horne or other Display Home? <br /> ❑ Yes allo If yes,a special event permit is required with Police Department and City Council approval <br /> 60 dais prior 10 rhe evenr. Shurrle bus service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. Noxi-permitted events will not be allowed <br /> NAME OF OWNER: L C!' r., PHONE.' <br /> ,�,( (i (bona) <br /> (wo&) <br /> MAILING ADDRESS: �5,W M e,` _CITY: ZIP: <br /> CONTRACTOR: ira 1-A G PHONE; 7Z��31s- <br /> CONTACT PERSON; MOBILE/PAGER: - / <br /> MAILING ADDRESS: CITY: & <I IZIP: oll Al <br /> STATE:LICENSE: # EXPIRATION DATE: 3210 <br /> ARCHITECUENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): PL- 1041'el-pi <br /> CInaad SlZzS <br /> STORIES: _r____ SQ.FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS:- GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ /7 V V <br /> I hereby apply for a building permit and I aclmowledge 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 1 understand this is not a permit and work is not to start without a permit;and that the work wil l be <br /> in accordance with the approved plan. <br /> APPLICANT'S STGNATURE: DATE: <br /> -rte <br /> 31 <br />