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Total Fee: $ I Date Received: <br /> Entered By: Permit#: <br /> CITY OF O�ONO - BUILDING ERMIT APPLICATION <br /> All information must be submitted in f 11 b fore plan review will be started. <br /> (please pf�int all�inf rt�tation) <br /> -------------------------------------------------------------•---- ----------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OW�iE OR C�NTRACTOR <br /> JOB SITE ADDRESS: �y� �� �A i S��c �'��� ZIP: 5�S3�� <br /> Will this be a �arade of Homes, Remodelers Show ase Home or other Display Home? <br /> ❑ YeS � NO If yes, a special event per•rnit is��equire with Police Depa�•tme��t and Ciry Council approval <br /> � 60 days priar to the event. Shzrttle bzrs s rvice will be requi�•ed unless applicant cfemonstrates <br /> sz fficient on-site parking is available. on per�milted events will not be allowed. <br /> NAME OF OWNER: /�D �%''�''` � ��� '�^� `''��' PHONE: (home) y5`� — y�,2 — y�i� <br /> � (work) �;�� '4 7� 'SiG o <br /> MAII�ING ADDRESS: �`�� S ��� � �� CITY: f��o�1 c7 ZIP: 5 S 3.59 <br /> CONTRACTOR: ~�,,c-.�,e � �� .�i PHONE: ��.2 -s�s D- D� 9� <br /> CONTACT PERSON: �'o•�� EQ� l��OBILE/PAGER: '� <br /> MAILING ADDRESS: 3 yv ��� �� CITY: ���� ���P ZIP: �535� <br /> STATE LICENSE: # ��iS XPIRATION DATE: <br /> ARCHIT�CT/ENGINEER: /l�!��-;--- PHONE: <br /> MAILING ADDRESS: ' �ITY: ZIP: <br /> NAME: REGISTR.ATION: # <br /> TYPE OF WORK: New Additio Accessory Structure <br /> Move Home emodeUAlteration � <br /> � <br /> PROPOSED WORK(desci•ibe in detai�: �� �4 °� GJ r `t c�o c.�S � 5���� <br /> t���/ �o � '�: � G�c�5 � 5�O�� v r� t�� i S �.�� /`fo�� <br /> � <br /> STORIES: �� -� SQ.FEET OF EACH LOOR: • <br /> NO. OF BEDROOMS: GARAGE STAL S: ATTACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION( xcluding land): $ �� UU C-% <br /> I hereby apply for a building permit and I acknowledge th the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances nd codes of the City and with the State Building <br /> Code;that I understand this is not a permit and work is not o start without a pennit;and that the work will be <br /> in accordance with the approved plar�,, . � <br /> APPLICANT'S SIGNATURE: �� � ��� DATE: �— /�C-.= - cu S� <br /> 31 <br />