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r <br /> Total Fee: $ Date Received: <br /> Entered By: /'�"� c---� Pernut#: ' � d�-`�� � <br /> �,� <br /> CITY OF O�RONO - BUILDING PERNIIT 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) OWNE �OR CONTRACTOR <br /> JOB SITE ADDRESS: ��"�U ��? ��� ��� ZIP: �S -�� � <br /> �(h�f � <br /> NAME OF OWNER: �'Jr�t� �L(.���v�� �� PHONE: (home) ��/-8 s <YS <br /> (work) �(7 I -o�07 <br /> �TAILINGADDRESS: ��{�v �ct/foLu�' ya�%��CITY: �/v��� ZIP: .5�`3q � <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> �RCHITECT/ENGINEER: PHONE: <br /> �IAII.ING ADDRESS: CITY: ZIP: <br /> NAME; REGISTRATION# <br /> T�'PE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration k Land Alteration <br /> � � <br /> PROPOSED WORK(describe in detai�: ������� -3 �✓��2��US Gr���,u��ar <br /> S�j �c � 5<2--� _ <br /> STORIES: 1— SQ. FEET OF EACH FLOOR: /�� � <br /> NO. OF BEDROOMS: 3 GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �G'J <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and <br /> accurate; that 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 /> permit; and that the work will be in accordance with the approved plan. <br /> i� �/ � � <br /> APPLICANT'S SIGNATURE: �'d/l �fi� v' DATE: � " �" CU <br /> / <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non pernzitted events will not be allowed. <br />