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08/23/2e01 10: 01 6128088846 ABC PAGE 02 <br /> �w.—��-�uu� uo,cyam rrom-CITY OF O�ONO +95�2484618 <br /> T-665 P.002/003 F-61T <br />'�'�j2�t� 3/ � <br /> To:ta.t F�: $ (�• 7 Date Received: $��3.�c� <br /> ; <br /> Es�tered By; p��t�: <br /> � � �' <br /> �� � CITX O� O��NO - BUILDIl�G pEl�iVIIT APPY,ICATION <br /> � <br /> �I��� - <br /> . � A.11 inforn�atfon must be submitted ln full before plan review wilt be started. <br /> (please print nll i�{fo»nation) . <br /> ----•---- - ------------._____..__._,--__.._� .�. ------ ---- --- <br /> . TI� �d1PPLICAI'dT T9: (circle one) Q�NER pR w CTOR <br /> JOB �iTE ArIDRFSS: eJ 6���ef'' I�OGLG� ZIP: <br /> . <br /> 1�►I� OF 0'�'1�TER: ��rc� 60l��va�.k Pxor�: cn��C�a -���- I� <br /> work)� <br /> hL�,ILYNG AIIDRESS:�aJ��a'lde t' �, CTTY: Q'�D t1,c� ZII>: � . <br /> �dNTRACTOR: ��i � - PHOlVE: al,S����"�SGI <br /> �ONTAC'Y'PER,SON: , � ` �. ' MOBII�/PAGER: �'— <br /> 1t�A�T�.YNCr A:DbR�FS�► . � � iCO� e, �S � CIT�t': l.t�-t'1Sy`i�l G ZIP:s��� <br /> ST�iTE LICENSE: � <br /> ,�,t��YYTECT/ENGII'�EE�t:� PHONE: � <br /> �1eaiII.II'�1Gr rA.DDRESS: CITY; �Yp: <br /> ��� REGIS'�R.ATION# . <br /> � <br /> TYf�E p�WORI�: �ew Addicion Accessory Saucture <br /> Move ltemodellAl�eratlon I,and ,Alterarion <br /> P�OP��ED�VOI�K(describe in deTain:�Qll�"' �(Uc� �(�Q at'y� L��,. <br /> l <br /> STORIE9: SQ.FEET OF�;AC$FLOOIt: <br /> NO. OF$EDROOM�: ` GARAGE STALLS: ATT. DET. <br /> ��T]1WIATEA CO�VSTRUCTTON VALUA�ION(exclud.ing land); $ `�� �QD ,9% � <br /> I hereb.y apply for�buildin,a percnit and I acknowledge that the information above is com,plete and <br /> ac.curate; tt�at the vwork wiU be in eonforuia�ue with the ordinances anc]. codes of tbe Ciry and with <br /> the 5taie Building Cod�; t,bat I understand this is not a permit and wark is not to start withou�a <br /> p�rulic; and rhat the work will be in accor ce wath the approved plan. <br /> �iPP`LT�'.4NT'S STCNA►TURE•���►' I, DAZ'E: ' c�o�� � � <br /> �, <br /> NOT,�! ppr,�de o,��Q�nes �vents require separate permit approval by PolSce Department and <br /> Cfry Councit 60 days prior to the evenr. Norr permitted events will nvt be allowed. <br />