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. � CITY OF aRONO = BliZ�DING PERMIT APPLICATION <br /> Total Fee: $ f,,��.<�'�/ - --- Date Received: <br /> Date P.pproved: <br /> Entered By: � �',�,/ r-, <br /> Permittt: �(���� <br /> AT•T• INFORMATION MIIST BE SIIBMIT'�� IN FIILI� BEFORE PI,AN REVIE�n1 WILL BS STARTED <br /> (See Check-off List Enclosed) <br /> ----------------------- <br /> ------�----------------------------------------- <br /> THE APPLICANT IS: (circle one) �OWNEF� or CONTRACTOR <br /> . _ , - <br /> -- _---- � <br /> JOB SITE ADDRSSS: ? ��� � I � �' � ,L_L_� C� I���-__C� ��:: ZIP: ��-� � �� � <br /> (work) <br /> N�ME OF OWNER: ��_� • �u� �C�c� '�� PHONE: (home) ��� � C� ��-�. <br /> _ .r �--�--- ?r- <br /> MAIZ,ING ADDR.ESS: 5 Z3 ( �S G� �6�c,�F' CITY: �+Cs Y\ (� ZIP: -��->-- � I <br /> CONZ'R�CTOR: � L �- f^ PHONE: �� � � �� =� 7.� <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: � <br /> ARCHITECT/ENGINEER: PHONE: <br /> :+�AII.ING ADDRBSS: CITY: ZIP: <br /> Z,J�: RSGISTRATION u <br /> TYPE OF WORR: New� Addition Accessory Structure Move <br /> Demo Remodel./Alteration Renovate Land Alteration <br /> � <br /> PROPOSED WORR (describe in detail) : � ���- t� <br /> ► <br /> STORIBS: SQ. FEBT OF EACH FI,OOR: <br /> NO. OF BEDROOMS: GARAGE STI�LLS: ATT. DET. <br /> - -> <br /> ESTIMATED CONSTRQCTION VAI�IIATION (eacluding Iand) : $ <br /> -:> �; O Ci , `=.� <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accor�3ance with the approved plan. • <br /> // � _ <br /> , �� �,:�� c, DATE: E�' � �� ��� <br /> APPLICANT S SIGNATDRE: �t ' <br /> � `/ t. <br /> ; <br />