|
Total Fee: $ �c L G� Date Received: �/9-D �
<br /> �ntered Ey: � � �crrYu t#: J d 7 0
<br /> L��'�` �-1� -�-1 �,. .
<br /> =� .;��� CITY OF OTtONO - BUIX.DING�ERMIT APPLICA►TIOI�7
<br /> All anforznation znust be submitted in fu11 beforc plan�evYew will be sta�ted.
<br /> (please pri�it c�ll ircfornaation)
<br /> ..r- ... ..- ... -•----- -s.�----��r.-------------r..-------•-----.�.------` -------..� ----
<br /> �������.....� �.�� ��.�.r ���. ����� ����
<br /> THE APPLICANT IS: (circle one)�OWNER OR CONT�2ACTOl�t
<br /> -•y'— '�•� , -, c�
<br /> ,j` �Z 1 L.� t ��,� `' '� . � . s � '` c-'' ZIP: /'� �- i
<br /> J�k SITE,ADDRESS: ,_., . Y � '
<br /> 'Wx),1 this be a Parade of Ho�es, Remode�crs Shovvcasc Hom�e or other Dtspaay�iome?
<br /> � 'Yes �No If yes, n special eve��t permit i.s reqicired witlz Police Departnierit a�zd
<br /> ,`���i�t c��'-`� �'\ Ciry Council a,pproval 60 days prio� to tlie event. Non-pCr�nitted
<br /> ��;��r� , events will raot be allowed.
<br /> ��; c� '� .. . �
<br /> �,:i.-C ._--- ( -,,. � �
<br /> � �� ' �.�� /'
<br /> NAME OF OWNE�• '�-. 1 ��' '1 �' � �;,.'J� �� �.:� PHONE: (home) � �- `���<< ,
<br /> ' ' !
<br /> � � � (w07Ck)�7,`,�� �'''�' , � i J
<br /> ��,`r�,�.�,� � . - -
<br /> MA,XLING ADDRES5: -�:% `; i �:- CITY: �.��r, _ t<' I:�; �,� , >,; /
<br /> i , r.' �--y+r
<br /> CONTRACx'OR: '�' r• : � C:._. P�ON�:
<br /> CON'�ACT PERSON: �VIOBIL.E/pAGEYt:
<br /> N�1,X�ING ADD�S5: C�TY: � ZIP:
<br /> � S'�,A.TE LXCENSE: # EXP�XZATION DATE:
<br /> ARC�TECT/ENGINEE�t: PHON'E:
<br /> MAXZ.,ZNG A,DDRESS: C�TY: ZIP:
<br /> N��: �tEGIS1'RATXON#
<br /> '�'YPE OF WORK: New Addition Accessory Structuze �
<br /> Move Home �2emodel/Alterataon
<br /> ...., � � . � � ��, , �y
<br /> PROPOSED WORK(describe in detail): ' ' '' - ,' ` � �
<br /> �r` i:� � ;� •� 1
<br /> ,,• ,�\ , i . 1 J�,. 1�•, �•,
<br /> 4:; � �y..�,. , ; ;� ,�_ . , , � � ,r
<br /> SQ.FEET OF EACH k'�.00Zt: ' ' �• � �� �
<br /> STOR�S: ��- '
<br /> NO. OF SEAROOM5: �� � ' GA,RAG�STALLS: A,TTACHEA Y DETACHED ',;,:
<br /> 1 , �'��
<br /> ESTTI�ATED CONSTRUCTXON'VALUATION(excluding land): � � � `-'� `�' `-' '
<br /> W`,J � �;�•,r'�. �:��
<br /> � ��,�,
<br /> I hexeby apply for a building permic and 1 aeknowledge that the informati.on above is complece and accurate;
<br /> that the wozk will be in, conformance with the ordinances and codes of the City and with tt�c State Building
<br /> Code;that I understand chis is not a permit and work is no�to stazt without a permit:and that the work wi�l be
<br /> in accordance with the approved plan. � � ��
<br /> � C . y /j ` � �' �
<br /> �, �; ' i f�� �. . r��/, :� ��.�_';
<br /> APPY,�CA,NT'S SYCNA�'�TRE: ' '' /t,�'f�;� ?:�� r� •..;�. �!�.ti'�� DATE: '� ; � ,
<br /> ,' �
<br /> J 9 �
<br /> T 'd EOE6i6bZS6 iooyog atppzW maznpue.�� e9S �OT b0 6T -�dd
<br />
|