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<br /> fl APF����I'o'Y�] �e�'� T �'-�� DateReceived: �' �� ,���-'�
<br /> ❑ ^,PP�� ��n�efi��d $j��,� � �f � � " n�"�n1"Lr� Permit#: ��/(!,,�;�/
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<br /> ��, , ,_ ..�,� �; �� �� .:,;:C, ��� 0������ - BUILDING PERMIT APPLICATION
<br /> Rs�i�;:�:: �,,.c:: � .,,, ;� �,. ,.. �,��c,,;c� �•. �eview.
<br /> l�:i:�-' 's,',1� �'i.,<�e,ti �;�"i �:`i�� �3i'i'�.:A���i:_L�i IPIiC:?.i
<br /> All information must be submitted in full before �lan review rvill be started.
<br /> (please pri�it a/l infoj�niatio�i)
<br /> ------------------------------------------------------------------------------------------------------------------------
<br /> THE APPLICANT IS: (ci��cle one) �OWNE R CONTItACTOR
<br /> �j � CJ r�� � � ` � � ���
<br /> � JOB SITE ADDRESS: � � � ����J�J��� 1�� ZIP: ..��u %� O
<br /> Will this be a Pai�ade of Homes, Remodelers Showcase Home or othei•Display Home?
<br /> ❑ YeS � NO If}�es, a specra!event per•mit is required�vich Police Dep�u•tnrent ar�cl Ciry Cour�crl approva!
<br /> 60 dn}�s prior to the event, Shc�ttle Gus service tivil(be required unless npplicant derno��strates
<br /> sufficient on-srte parlcir7g is available. Nori-permitted evejits rvrl!not be a!lowed.
<br /> I`�TAlV�L'�'�;�Jrl�D: (/� ��';�t'�, �/��9Gi U'G���✓'C�� P�-��1`lE; (home)�J������_" �.�1��
<br /> /� -, �,� > (work) �< . if��� �- �5��.�
<br /> MAILING ADDRESS: /"r �� �'��' .%J 7 CITY: C�(;���u�e' ZIP: �' ".�.5 ��s'S5�
<br /> �O1�TP.ACT�F.: �` �� PI�ON�:
<br /> CONTACT PERSON: n�' '/� MOBILE/PAGER:
<br /> MAILING ADDRESS: Ci7C�: ZIP:
<br /> STATE LICENSE: # EXPIRA.TION DATE:
<br /> ARCHITECT/ENGINEER: J f�t' �l,^"`>�i�%n� PHONE: 7�.3 - y��''�S'G' ,'
<br /> 1ViA1LING ADDg21ESS: CI��': Z�P:
<br /> NAM�: R�GISTI�ATION: #
<br /> �'yPE. cJ�' W���{: New Home Addition x Accessory Structuce
<br /> Move Home RemodeUAlter�tion (ie: Siding, Windows)
<br /> Any earth movement may require MCWD review and pe-rmits !,
<br /> �I���O�ED yV�3R�(desct•ibe irr detai�: CC�!/���ivr5 �tiilLi��i �/'��'�i�/ ����i,�r�i� �`,��r� � v��,�
<br /> � G /�? � IG({��C!/' /`c /)' ^ �"�/i/ � � �✓(jW!t✓c•`'C�,�'iT��n "f,.�d �?n ,�,fJ° i�i��,i'
<br /> � J � '�I��L v'r/7i��,i
<br /> S'�'ORI�S: d SQ.F'EET'OF Ef�C�FLOOR: I ��-;� ;,���r'�' �u i ll�
<br /> I�iO. O�' BED�ZOOIVIS: �-�rU �ARAGE ST'ALLS: A'TT'�.C�E� �/ ��'�'�C��'�_ i�?' ^�t�,�-y��
<br /> P f��j./.J �'�j';
<br /> �S�'�I`o'IA�'����I+dSB'I2LTC7'��N�iA��JA�'I�I� (excll�d'eng laaacflj: ��f c��J, � -��1��.�,.
<br /> I hereby apply for a buildinQ permit and I acknowledge that the information above is complete and accurate; ��V '�j ;�,,,�ir�
<br /> �d �'',�: �
<br /> that the�vork�vill be in conformance with the ordinances and codes of the City and with the Scate Buildina ,�,i ;a �f�r,�,r;,
<br /> Code;that I understand this is not a ennit ancl�vorlc is not to start���ithout a eri��it;and that the�vorl:���i ll be �"��'
<br /> P P -��.�fr'_'/f�;m,
<br /> in accordance with the approved plan.
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<br /> A�'P�iCA1�1'�'�5 S��id��'U��: l/�� %�` /1� ���'``�� �'^��'F; �f c`� �'1�
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