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' -' <br /> 4 <br /> Total Fee: $ - Date Received:/' __2 <br /> Entered By: 'k. •r - Permit#: 6. tar - a)S45:01..z_ <br /> CITY 4., ORt - BUILDING PERMIT APPLICATION <br /> All informati \i mustAbmitted in full before plan review will be start J. <br /> °ease print all information) <br /> i- _ <br /> THE APPLICANT IS: (circ '(;r l<e)C OWNERJOR CONTRACTOR N <br /> UlM �f � <br /> JOB SITE ADDRESS: I _l y t , d�NZaIP1 SS No, <br /> 3 <br /> Will this be a Parade of Homes,Rec�t �elers Showcase Home or other Display Home? <br /> 17 Yes {'No If yes,a special evert•mit is required with Police Department and City Council approval <br /> 60 days prior to the - zs. Shuttle bus service will be required unless applicant demonstrates <br /> sufficient on-site par itht is available. Non-permittedLevents will not be allowed <br /> NAME OF OWNER: :tki i(,1c v-'r 1 1+'D2i'l k) PHONE: (home) 9S 2-4710-7469 <br /> (work) b I Z-941A-91782 <br /> MAILING ADDRESS: SAVY1C- CITY: ZIP: <br /> CONTRACTOR: SAIF PHONE: dl S2'-I)l0" LI 7 <br /> CONTACT PERSON: j MOBILE/PAGER: (4-11-202_-c7$2- <br /> MAILING ADDRESS: S A At - CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: 4air{S De- ;?k) PHONE: q 5 Z--We 2-`i 0(o <br /> MAILING ADDRESS: I%33 Coitiec.lowe✓ Llv, CITY: ZIP: <br /> NAME: RoVzA- i\at rc.v'1- REGISTRATION: # .W(,, ?3 y <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home RemodeUAlteration(i.e.:Siding,Windows) <br /> im a ,,tt 0/,',,3°i: i<r fich +'c(f,'1:7a 1/( I1 /) RI'tli'?` (I/ I A,;, ;.IJ' <br /> PROPOSED WORK(describe in detail):t1 RPI4� 404"--11—..,_..... <br /> i. heij2„ Ow,-� cci.,- © ec,1V C(S j d is <br /> LcN docr c Z Tc-97R(, `I272 <br /> STORIES: SQ.FEET OF EACH FLOOR: Secc�cV S$0 <br /> NO. OF BEDROOMS: 5 GARAGE STALLS: ATTACHED .x DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): 4 30 0 I �O0p � <br /> I hereby apply for a building permit and I acknowledge 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 I understand this is not a permit and work is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANTS SIGNATURE: DATE: /2--15`)- <br /> __L„ s- A <br /> L .,, <br /> 3l <br />