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� + � <br /> Total Fee: $ ` G�� -5 � Date Received: �- �Q -�j j <br /> Entered By: � Permit #: f} �;�./� �f <br /> � ���'�� � � <br /> CITY O�ORONO �BUILDING PERMIT 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 CONTRACTOR <br /> JOB SITE ADDRESS: ���f's f.�/6/� L/r! ZIP: �J S.�S � <br /> NAME OF OWNER: /��/�N���'J�f/�ti.�i��/�,�ir�PHO�TE: (home) �jJ~L�`�� - ��s`�9 <br /> (work) "7�3 —y��� 3 U76 <br /> MAILING ADDRESS: �y-�t> /�/�f� « CITY: G o.�� c.q�� ZIP: S'1'3�G <br /> CONTRACTOR: .f�fC� PH0�1E: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: _._.----� —' PHONE: <br /> MAILING ADDRESS: �' CITY: ZIP: <br /> NAME: REGISTRATIO`T# <br /> TYPE OF WORK: New i� Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: _ ft/�1'� , '3 c/�Z 1 Z z'� 3 y�." � ��'-�r�� <br /> � n�j� �- '-, ,�1 � <br /> i���-�^7�=G �/�� ��c1iGlG'�/�2G)/�4rY�'r% %-��� l/._��cT— ��!�:7 /� Ci�/2l��-�'' <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTi, /DET._� <br /> ESTIlVIATED CONSTRUCTION VALUATION(excluding land): $��// 3 �� <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 /> �� � <br /> APPLICAP,T'SSIGNATURE: � DATE: ���2 ��U/ <br /> �.' <br /> NOTE! P�rade 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 /> 9 <br />