Laserfiche WebLink
, �, <br /> 1 ' nq Perm±t. A�plication � �� ���-� <br /> ! <br /> i�SURI'3 �Yil�� � <br /> �T� �p "" DateReceived: � �Q'(�� <br /> �nte� �y: Permit#: <br /> Reas�n�s� fo; r�e^:al: _ �:: � F�'•c t� <br /> ��:-�. riTv nF nunlvn _ gU IL;I�ING PERMIT APPLICATION <br /> _ ��,��� 1��=^� <br /> St3(t. �-'� All infor����p '�" u���e submitted in full before plan review witl be started. <br /> (please print al! informution) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPI.ICANT IS: (circle one) OWNER OR CONTR4CTOR <br /> JOB SITE ADDRESS: 7�� ��.����. t� , rs�. zIP: <br /> �Vill this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �lv0 If yes, a special event permi!is reyz�ired ivith Police Department and City Council approval <br /> 6(J days prior to the event. Shutlle bus sei-vice will be required unless applican�demonstrates <br /> st�fftcient on-site purking is avrAilahle. Non-permitted events il�ill not be allowed. <br /> NAME OF OWNER: 'rR�O��Fz.(3 j S�"��L PHONE: (home)y�2-�13--�9G6 <br /> (work)�12.-a'I`%-�j 2?`� <br /> MAILING ADDRESS: �l�S ��c�►�p,o<� 2A.N. CITY: DtZ��c� ZIP: Ss35 r <br /> CONTRACT'¢JR: C�S�-�T�S i3�iw i..�� C.�,Z,(� PHONE: �J�Z- yn�—�3 6 C� <br /> CONTACT YERSON: �Av 10 �i�2�rAS _ NIOBILE/PAGER: �1 Z -3� 3 -388� <br /> MAILING��DRESS:a1q3� N�►.wu�.Ta•-1J� l�W�. CITY: {��Lf/�EL_ ZIP: 33 i <br /> STATE LICENSE: # � �`� � EXPIRATIO�V'DATE: 3 �'3/�p� <br /> :�RCHITECT/ENGINEER: }��4�L ��a.i N�-� S,F�� adZ�,yS PHONE:�l SZ-'�6'? -,3Z�1 <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATIOti: # <br /> TYPE OF WORK: New Home Addition �_ Accessory Structure <br /> Move Home Remodel/Al:eration (ie: Siding, Windows) <br /> Ar.y ea.rt'� movement may require MCWD review and permits ! <br /> PROPOSED WORK(describe in detuil): ,Ap4��c�..� A-�'o t��p,£u--�� 7a �/S��-�� <br /> '� I Q�i..!C� <br /> STORIES: 1 5Q.FEF.T OF EACI�FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> � <br /> ESTIMATED CONSTRL'CTION VALUATION (excluding land): $ 3�� C�'aC� � <br /> I hereby appiy for a buildina permit and I acknowled�e that the information above is complete and accurate; <br /> that the work���ill be in confo ce �>> e ordinances and codes of the City and ��ith the State Buildin� <br /> Code;that I understand thi :s not a permit an vork is not to start without a permit;and that the work will be <br /> in accordance���ith the ap oved p1an. <br /> .\ ,, <br /> APPLICANT'S SIGNATURE�,�__ � `'��r� �ATE: � ✓J 0� <br /> 3t <br />