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N D� I 5 � u� ��►� ���� ��� <br /> Total Fee: $ � � . �''�� Date Received: '� �a-1 C� <br /> Entered By: Permit#: 1"��`� 9�9 <br /> CT'T'`' � TO - BUILDING PERNIIT APPLICATION <br /> '�,�-, `��_� ,,�,�.F.,; <br /> � � ��� submitted in full before plan review will be started. <br /> �5 � ,nc\ti. <br /> ;� �� �,�, ?l � please print all information) <br /> ------ 5� �,P�'nS � ------------ ---------- - <br /> -------------------------------------------------- <br /> \�V�� � ��� <br /> THE i � �`' � ���nF"� � � one) OWNE R CONTRACTOR <br /> ����' � ,\c•� i- �, <br /> JOB 5 � .��������_��: (o,�O • �' ZIP: ����5 <br /> NAME OF OWNER: ���*�r�� ��Qy���y/��✓r�� PHONE: (home) �� `�Z/9 <br /> (work) �� <br /> MAILING ADDRESS: ,d,g �S� CITY: a��^ ZIP: .�;��S <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAlLIl�G ADDRESS: CITY: ZIP: <br /> STA"TE LICENSE: # <br /> ARCHITECT/ENGINEER: �i n�P ITih�tx ,p�}i�`� PHONE: 9���' 7��� <br /> MAILING ADDRESS: �b �,(�, 7$ S�. .��;�r?/dCITY: �/��;h��,��k ZIP: � <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition X Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PR POSED VyORK (describe in detai�: i �a�t ,�(� ✓ �� v � <br /> Z � s , e /vr s . <br /> STORIES: � SQ. FEET OF EACH FLOOR: Z�(�• <br /> NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ���, d(�.� <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 ith the approved plan. <br /> APPLICANT'S SIGNATURE: � � DATE: Z 0 <br /> NOTE! Parade o�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 /> 9 <br />