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� � <br /> . , '"� <br /> , � � � <br /> Total Fee: $ ' C'/�` Date Received: �- ,��- U J <br /> Entered By: ,�'�g.�, Permit#: �� �) �f��(�,� <br /> �- � � , ��� , � , <br /> CITY OF �RONO - BUILDING PERNIIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: � ��b CtE-�5.?�e� ,l�C J F• ZIP: i S 3!��/ <br /> NA1�IE OF OWNER: ���iJ; � J,�� ��,.�,2 T-�ri PHONE: (home) 9Sd-�{��-tv�'S 6 <br /> (work) �id--�04- f�fol� <br /> MAILING ADDRESS: ��� (, C��-,/l,.Q y �¢v� CITY: d2�,�lo ZIP: �S (o <br /> CONTRACTOR �r¢J S CUn�J r r����n.�i l�V C. PHONE: Q�� �`1�71�- �5�t� <br /> CONTACT PERSON: �u„� L<�p��G,��;� MOBILE/PAGER: (,,!,� . 41�_ (�a.3 g <br /> MAILING ADDRESS: f�,� C�;'�,2�t-" J r. CITY:C—�cr�c �rcl,C ZIP: S S 3,3 j <br /> STATE LICENSE: # ,�3SU S <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition�_ Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: ,Q���7-��,y ;-� ��;�� v,J ������; <br /> Cc/�^l C�/L <br /> STORIES: ( SQ. FEET OF EACH FLOOR: (� 7t,L <br /> NO. OF BEDROOMS: T� GARAGE STALLS: ATT. � DET. �" <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �7 0�� � <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 with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: .��', < <br /> NOTE! Parade of 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 /> 5 <br />