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NOV-02-01 05:06 PM TWIM CITY ROOFIHG 7663@16 P.01 <br /> (;� C' <br /> Tota 1 �'ee: � 02�_,��� Date RecPiWed: l/ -S "C5/ <br /> Encc;red $y: ��,�___._.._____..._. 1'err.nit#J: ,,� ,,��� -._�__.__ <br /> --�-!_�=v_��sL� ...�. _,. <br /> CITY OF O�,ONU - BU�DING� PER.MIT Al'PLICA'I'iON <br /> All informatiou must be subnutted in full before plan review r��iIl be started. <br /> (pl�a,se prir��ull infvrnuz�ion) <br /> ------------------- <br /> 'I'H� APYT.TCAIv'�' IS: (circle one) OWriER O CON'TRACTOk <br /> ��. l `. <br /> JQ13 SI7'k: �iDDK�;SS: _� , �,� � �IP: .�---_.__---------- <br /> '��� C� <br /> NA.�� OF O'w'N�:R: �� `{...��-'���._���. � -- PHO\'�: (home) <br /> C (work) �� � `�.���7�� <br /> �r�II..,��� ,az�v�:�ss: 1�`J �-�+ ►���ci���;_����.�....z�'�.----- ._.__ <br /> �,�r�1 J��'�:1�.-j 1��: ��\,4.��.�.1��,.����\l.l.._�.�"-.;1 _— PHQ\�.: �'��� �_SL.�L,C_....I_.��C� <br /> CON'1'AC��'C�2.SU�i:__1=.�.`'.�: _:_______.._ � MO�Y�E/PAG��� <br /> `�T[,II�G A.DDFZESS: '_ (G�� ' � _.._......_..---.._._�.CITY: .`���,�__�z�': -..�a�� <br /> STA'I'E: Y,IC�:�'SE: f���,�:�-� <br /> 3 <br /> A.RC��I f k:CT;'ENGi�,ti'��',�2: .-.._ ._.----� --- PHO:�TE: -----�- •--..__� <br /> . . ..... <br /> I1�r�3LT�''G?�D�SS: _.._ _--- - ..-----.....__. �,___CIT�': _---,_�.�..ZIF't _—.—._. <br /> Nr�.:V1F,: _�REGTS'T�R�T'I4tiT�" <br /> T"YI'� Q�' '�VOItIi: New Addici�n Accessory St�uccure__i____�_ <br /> Move _._____ , Remodel/A.ltzration ,�, Land .�lteraCion _ __. <br /> PRUY�S�;D ti�'0�2�i (describe in deta�`�: �_��, �'e�;.._��j� � �.5���� <br /> � <br /> STORIES: _ S�l. FEE`T UF`�;ACH�J�40�t: .. - ------ •- ----- .-�, <br /> NO. OF BEDR00:�1S: �__. GrAR4GE S'T'AT�T.S: ATT. _, D�T,�_ - <br /> EST�I,ATED Ca�l'STRUCTXOi�' VAI.UATtON (excludin� land): $ ������ <br /> I her�by apply for a building permit and T ac�owledge that the infot�uiation above is cocUplete and <br /> accurace; thac the work will be in confvrmance with the ordinances and eodes of the City and with <br /> che St�te Building Code; that T understand t�his is not a permit and vvork is noc co start without a <br /> permit; and that th� wark will be i.n accordaace with the approved plan. <br /> � � n <br /> AF�'T.IC�\T'S SIGi�AT'CT�t�: � �—'� . AT'E: �`�� _.l-- <br /> �� <br /> 1�'QT�;! ,P�ra-de o I�iome.� events require separate permit approval by Police Departrne�:t and <br /> City Cauncrl 60 days prlor to the event. Non permitted events will not be allowed. <br /> ............................................. ... .............................. . ...................................................... <br />