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' CSTY OF S�RONO - BIIII.DING PER3�iIT APPLICATION <br />� � �---- �� . �a L <br /> _�___P�" L�/• � L, Date Received:L�"� � / <br />� Fee: $ I� � - <br />� Tota1 <br /> Date A�nrove�: � <br />� Entered Bv: C�� Permit�: c� �'� 7 - _-- <br /> f AT•T, IP7gOg2dATION MIIST BS SIIBMITTED IN FIILL BEFORE PLAN RE�7SEW WII,L BE Sg��� <br /> (Se� Check-off List Enclosed) <br /> ------------- <br /> ggE p�ppI,IC1�NT ZS: (circle one) 0�1NER or CONT_�ACTOR <br /> � n �� ��� <br /> ���� /h ��'v�'i'�� �%� �� zzP: ' <br /> JOB SITE ADDRSSS: / i ' q/rj <br /> (work) �,�� <br /> L ' � �; PHONE: (home) � / �J <br /> NAME Of �WNER: '. /� � V . <br /> C � CITY: ZIP: <br /> MAILING ADDRESS: Jl/��� — <br /> / � PHONE- <br /> CONTRACTOR: <br /> �� i��'� <br /> CSTY: ZIP: <br /> MATT.ING A.DDRESS: <br /> STATE LIG-�NSE: z <br /> PHONE: <br /> ARCHZTECT/ENGINEER: <br /> CI�•�,: Z IP: <br /> MATLING ADDRESS: <br /> REGIS'�^FZ�TION a <br /> NAME: <br /> Accessory Structure Move <br /> �pE pg Wpgg: New Addition Land Alteration <br /> Demo <br /> Re.*nodel/Alteration Renovate <br /> n�/�U'V �G��% <br /> PROPOSED WORK (describe in detail) - � <br /> STORIES_ SQ. FEET OF EBCS ��R: <br /> ��g�Gg STAT,T,g: ATT. DET. <br /> NO_ OF BEDROOMS:� � <br /> EST�TED CONSTRIICTSON VALIIATSON (e�ciudinq <br /> land) : $ ���'� <br /> I hereby apply for a building permit and I ac?cnowZedqe that the information <br /> above is complete and accurate; that the work will be in conform Code;�ithathe <br /> ordinances and codes of the City and wi.th the State Building e�it; and <br /> understand this is not a permit and work is not to start without a p <br /> that the work wi].1 be in accordance with the approved pl.a.n. �. <br /> � ' � <br /> /� ���',�"��-��-. DATE s � �� <br /> APPI.ICANT'S SIG2IATUFtE- � <br /> � � � <br /> � <br /> \�, _ : . . . <br />