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� -^ --- - <br /> Total Fee: $ ��fC� :S=' Date Received: <br /> Entered By: ili> Permit#: <br /> �.-G �y�� �/ / ���1 ��`l � <br /> CITY OF �R�NO - B�TILDIti'G PERi�1IT APPLIC:�TION <br /> All information must be submitted in full before plan review «-ill be started. <br /> (please print all information) <br /> ------- ---------- ------ <br /> THE APPLICANT IS: (circle o�:e) O`VNER O CO`"TRACTOR <br /> JOB SITE ADDRESS: Z�]�� {-��1� ��� �� , ZIP:J S�� <br /> Will this be a Parade of Homes, Remodelers Sho�`�case Home or other Display Home? <br /> ❑ Yes � No If yes, a special event permit u required with Police Department and City <br /> Cozcncil approval 60 days prior to tJie event. Non permitted events will not <br /> be allowed. <br /> � <br /> NA1vIE OF OWNER: I�-}C� � S��/��j MA�A.���Y PHONE: (home) `TSZ-�75-'�a5( <br /> (work) <br /> NIAILING ADDRESS: 2�0 f-�0��(�N��/Z 21� CITY: pl�b ZIP: �2�9/ <br /> CONTRACTOR: �F�11� ��C.,S PHO�`E:��3�S4�Z-9a� <br /> CONTACT PERSON: _C+fRI S Fr,STE� i IOBILE AGER: 763-3q� -qoo$ <br /> MAILING ADDRESS: 3�o S' �E�w�Y ►�9 N IT�': t�Ly�ou�'1� ZIP: S'� <br /> STATE LICENSE: # p,(' �Zp�4„� c�sZ <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAi�IE: REGISTRATIO\� <br /> TYPE OF �VORK: New � �ccessory Structure <br /> Addition l�Iove <br /> RemodeVAlteration Land �lteration <br /> PROPOSED WORK(describe in detai�: _ZDX4� ldl�,(�yuNlJ V�til S� L1 N£p Sw�rn in iiu 6 <br /> `FbO�- <br /> STORIES: � � SQ. FEET OF EACH FLOOR: N�� <br /> NO. OF BEDROOiVIS:� GARAGE STALLS: �TT. � DET. q <br /> ESTI�IATED CONSTRUCTION VALUATION (escluding land): $ 2('j,pQ <br /> I hereby apply for a building pernut and I acknowledge that the infc-_nation above is complete and accurate; that the <br /> work will be in conformance �rith the ordinances and codes of t�:� Cit�• and wzth the State Building Code; that I <br /> understand this is not a permit and work is not to start w-ithout a per.^.it; ar.d that the work R711 be in accor�nce with <br /> the approved plan. <br /> �� <br /> APPLICANT'S SIGNATURE: �G`—"' DATE: �" �9- n� <br />