Laserfiche WebLink
�°`�J <br /> . �`� ` , � <br /> ° c� ` �-� ��+U <br /> " ; `'�,� �� ' <br /> ����� <br /> Building Permit Application # <br /> '� I E D � <br /> (f� �r1'� Total Fee: $ Date Received: <br /> SF� Entered By: Permit#: � , ,,,� <br /> Reason(s) for deniai: ' <br /> CITY - IT APPLICATION <br /> �--�'=M=�-- <br /> All inform����� m tittec��ull aeview will be started. <br /> (please print all informat�on) � <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTO� <br /> JOB SITE ADDRESS: �a`�d L�.n;; �--;�{'�: ��� ZIP: s-`�:3�'`� <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes ❑ NO If yes, a specia!event permit is required lnith Police Depa�•hnent and City Counci!approva! <br /> 60 days pr•ior to the event. Shuttle bzrs service wi!!be reguii•ed unless applicai�t demof7.strates <br /> sufficient on-site parkin,�is available. ���on-per»aitted events tia-ill not be a/lowed. <br /> NAME OF OWNER: �c�� S����,.,t� PHONE: (home)�'�- �3�_9�.�9 <br /> (work) <br /> MAILING ADDRESS: J J�b`'� �},'(�.� /�-, CITY: �r ��.; � ZIP:S'S'�.j�, <br /> CONTRACTOR: �;,,�.r��,.�z,,� /,'L.� ,��/X�.� PHONE: <br /> CONTACT PERSON: �'J;�,,; d�s•.�_ MOBILE/PAGER:9�- �S�- ��s�� <br /> MAILING ADDRESS: /,���1�; �,�;�o /�. CITY:t7.�;,.,- � ZIP• 55 5�z <br /> STATE LICENSE: #,�r :zo s R�.f � � EXPIR.ATION DATE: � 3��� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING A�DRESS: CITY: ZIP: <br /> NAME: REGISTR.ATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration (ie: Siding, Windo�vs) <br /> Any earth movement may require MCWDlreview and permits ! <br /> PROPOSED WORK(describe i�:detain:�,� ��G'' c,r,,,�,f �{;- ��� o;�� �� {�:,-� <br /> STORIES: SQ.FEET OF EACH F'LOOR: <br /> NO. OF BEDROOMS: GARAG� STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ /Svez --.,�a"� <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that thz wurk 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 to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> � <br /> APPLICANT'S SIGNATURE: �%!i.-, 1 �` /���` DATE: l� ��ol <br /> 31 <br />