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,f�i c� n.o-� <br /> //i G���-�2, Date Received: /o � O <br /> �, �' Permit#• ,q-///00 <br /> RONO - BUII.DING PERNIIT APPLICATION <br /> Au �ntormat►on must be snbmitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: 35 3 S ��`-� � � . � r�'"' a �P: S S�3 � ! <br /> � <br /> Will this be a arade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �NO If yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be reguired unless applicant demo»strates <br /> su�`'icient on-site parking is available. Non permitted events will not be allowed. <br /> r�sz-�'7! - !l�{� <br /> NAME OF OWNER• �e �� �' �a �.' � PHONE: (home) S�t W�� -►!y � <br /> � (work) <br /> MAILING ADDRESS: 3 S''� �`�� f � • CI'TY: �r� v ZIP: C�3g I <br /> CONTRACTOR: P�O�' <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: �TY� �� <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCffiTECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: 7�� <br /> NAME; REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home RemodeVAlteration(ie: Siding,Windows) �_ <br /> PROPOSED WORK(describe in detain: Q�Q�� S��"�4 s�c '�r h���c�, 4,-�► � <br /> DC �h GPnCirM '�+ti W� �h CCC+O • - <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(egcluding land): $ <br /> [hereby appty for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and work is not ta start without a pernut;and that the work will be <br /> in accordance with the approved plan.� <br /> APPLICANT'S SIGNATURE: , '� � DATE: �a 2 L J 3 <br /> 31 <br />