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, � �� � <br /> � �l Total Fee: $ ' �,3�'• ) 7 � " , Date Received: � ��% �' <br /> � C . � <br /> �ntered By: ���,,--, ��� � emut#: �j�'�.�� <br /> � ��;��Q� � �� • ; <br /> �� ' � �� �CITY OF �RONO - BUII�DING P T APPLICATION <br /> gf��,;..� � <br /> J All information must be submitted in full before plan review will be started. � <br /> (please print all information) <br /> THE A.PPLICANT IS: (circle one) OWNER OR CONTRACT R � N ~� � � <br /> �l'-{ L-( r'�i �� � �- f f `� C�' <br /> JOB SITE ADDRESS: �'��c'�c L��-r�..��€�,� �_�s��z.-'�"" ZIP: ���� <br /> NAME OF OWNER: Ti n, ;� h�F h�r�'�� '�'��� � PHONE: (home) �5�- ���- I�L�'� <br /> (work) <br /> MAII.,ING ADDRESS: i az..� ����t�r��: t��:tiE�. CITY: 1�'1�r.R��,�i r�f�ZII': .��3l� <br /> CONTRACTOR: �^�����,� P:.�.!r�t� �t� . L,�. G. PHONE: �d�z- 3 3 s- ���r� <br /> CONTACT PERSON: S-�/� �i e.��t-'?' MOBILE/PAGER: C,��.- 8�q- szo�. <br /> MAILING ADDRESS: _z1� M�;����" �-�". CITY: ht�n,nr�"�Po c« ZIP:�$oS' <br /> STATE LICENSE: # Zo 13 5�� � <br /> ARCHITECT/ENGINEER: A 1.4.����.e-� �u�p �, ��.L.C,PHONE: to►Z- ���� .���� <br /> MAILING ADDRESS: Z,� r°�1,�.���� �r', CITY: i'�1��,u���-s�ZIP: S S$oS <br /> NAME: REGISTR.ATION# <br /> .:. <br /> TYPE OF WORK: New �/ Addition Accessory Structure '✓ � <br /> Move RemodeUAiteration Land Alteration <br /> PROPOSED WORK(describe in detai�: ��,�t,c.� �.�r r c.`� �?��C�f� � f��-����"�'7"f�4-C.,, <br /> �Z k �.2� L��"�P��T.� C�r�;�t�.�"w�z L, <br /> �z��� � �������. �.�;.r�::�,.. <br /> STORIES: � SQ.FEET OF EACII FLOOR: Zt���- � ����' ��. � 1aZ0 � Z�° �- <br /> NO. OF BEDROOMS: � GARAGE STALLS: ATT. Z DET. Z <br /> � <br /> ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �"��,� �4��` <br /> I hereby apply for a building permit and I aclrnowledge 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 BuildinJ Code; that I understand this is not a perm.it and work is not to start without a <br /> - .permit; and that the work.will be in accordance with the approved plan ,. <br /> . . . . . . ,,..;. � .- . .. <br /> �.. . _ . _ .. - <br /> .., <br /> APPLICANT'S SIGNATURE: "`` ���.G�i1`` DATE: ' -� �I — ��- <br /> NOTE! Parade o 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 />