Laserfiche WebLink
�1 o, . <br /> Date Received:_! 2 Q1 <br /> 4-7 Permit#: 4 4 y59 177 <br /> OF OR NO - BUILDING PERIVIIT APPLICATION <br /> _...,,.-cation must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER QR CONTRACTOR <br /> JOB SITE ADDRESS: ZIP: `�3, <br /> NAME OF OWNER: PHONE: (home) 55 <br /> (work) <br /> NIA LD,'G ADDRESS: 4//O(] j-Askrc- /I CITY: G ZIP: <br /> C' • PH0��3 <br /> CONTRACTOR: G)/2 <br /> CON�'ACTPERSON: �i ��� kl-z:� MOBILE/PAGER: `y�-y//&-- Jill yS�� - <br /> NIAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: ; ..T —PHONE: <br /> BAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF `YORK: New Addition Accessory Structure <br /> Move Remodel/Alteration ,'K Land Alteration <br /> j <br /> PROPOSED WORK(describe in detail): i� <br /> STORIES: ,\ SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTBIATED CONSTRUCTION VALUATION (excluding land): $ / ,;C a a <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; chat the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> peri'- ��d that the work will be in accordance with the approved plan. <br /> APPL-.CANT'S SIGNATURE: - L. �, ,i DATE: < > <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />