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� ` I <br /> j <br /> Total Fee: $ a C)57- 5 Date Received: 1k7 <br /> Entered By: Permit#: BYO 3O y <br /> TY OF O -O�j [LDING PERMIT APPLICATION <br /> All information ust be submitted in full before plan review will be started. <br /> (please print all information) <br /> ---------------------------- --------------------------------------------------------- ------ --------------------- <br /> THE APPLICANT IS (circle one) OWN /OR, OR <br /> S Z.�JOB SITE ADDRESS. IP:NAME OF OWNER: (home) 7 MAILING ADDRESS: ZIP: <br /> CONTRACTOR: D <br /> CONTACT PERSON: `'' MOBILE/PAGkR: �3 5 <br /> MAILING ADDRESS:'' 7 B =CITY: A IP:1��j <br /> STATE LICENSE: # ) <br /> t!" <br /> ARCHITECT/ENGINEER:YA, CI PHONE: <br /> MAILING ADDRESS: t ' CITY: L)Pj � , ZIP: S t <br /> NAME: REGISTRATION# <br /> I <br /> TYPE OF WORK: Nelbein <br /> Addition Accessory Structure <br /> Movemodel/Alteration Land Alteration <br /> PROPOSED WORK(d stail): V <br /> �) L,,p <br /> STORIES: `� SQ. FEET OF EACH FLOOR: \00- <br /> NO. OF BEDROO D GARAGE STALLS: ATT. DET.3 <br /> ESTIMATED C TRUCTION VALUATION (excluding land): L Z)®o. <br /> I hereby apply for a building permit and I acknowledge that the informati n above is complete and <br /> accurate; that the work will be in conformance with the ordinances and co es of the City and with <br /> the State Building Code; that I understand this is not a permit and work i not to start without a <br /> permit; and that the work will ba cprda ce wi the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: q �.� ' DO <br /> NOTE! Parade of Homes events require sepa to Amit approval by Police Department <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />