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� � <br /> � ' Total Fee: � ��5`- �� DateReceived: <br /> DateApproved: <br /> Entered By: �_ _ Permit#: ��;C�/�. <br /> � <br /> CITI�` F ORONO - BUII..DING PERIVIIT APPLICATION <br /> AI,L INF'ORIVIATION vIUST BE SUBMITTED IN FULL BEFORE PLAi�REVIEW WILL <br /> BE STARTED <br /> ------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICAi�1T IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: �7��� C c�rc����w<<� /��-� ���'e��u���� �'��,��� ZIP: � `� '`�� I <br /> NANIE OF OWNER: I�:.,�:����c� J. l� �4��y PHONE: (home) y/��1���Sl <br /> (work) %!!�- _���S� <br /> NIAILII�'G ADDRESS: -�:�>S<���.��i,�„��� ,-1�r, CITY: ;,;_c.����z�, �� ZIP: S�S�S�/ <br /> �. <br /> CONTRACTOR: ; e I '� PHONE: <br /> v10BILE PH0�1E/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHTI'ECT/ENGINEER: PHO�1E: <br /> MAILING ADDRESS: CITY: ZIP: <br /> �J��,�: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration � Land Alteration <br /> i <br /> PROPOSED WORK(describe indetail): �-� ,�t c.c�ti � � �-'��� �`�ti� C F> �= � , <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIlVIATED CONSTRUCTION VALUATION(eYcluding land): $ /_S��� ' <br /> I hereby apply for a building permit and I acknowledge that the information above is complete <br /> and accurate; that the work will be in conformance with the ordinances and codes of the City <br /> and with the State Building Code; that I understand this is not a permit and work is not to start <br /> without a permit; and that the work will be in accordance with the approved plan. <br /> / �� ; <br /> i <br /> APPLICANT'S SIGNATURE: 1 ��-���., �J ��f���, ��d-� DATE: s ' 1 � � <br /> NOTE! Parade o�Homes events require separate permit approval by Poliee Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />