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���.��� �� �� <br /> ` �� Fce: � $ / �7 � Date Received: q /0 <br /> f � ����� Entered By: '`, <br /> ;' �'� C ,' Permit,#: /-� �;�/a�/ro <br /> �. �y�'')C�f� ��/� <br /> , CITY OF �RONO_- BUILDING PE T APPLICATION <br /> 1 G-� , ��,`��y���� : �f .,;.:� <br /> / <br /> l� All information must be submitte� in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER OR TRACTOR <br /> JOB SITE ADDRESS: . � C� c'P �/ L l�.,��,��,� ZIP: <br /> NAME OF OWNER: /',�,�;��. ���� ���� PHONE: (home) -�� -�1�-p�l <br /> (work) <br /> MAILING ADDRESS: 026�'�/����,� CITY: C�� ZIP: ,f�'�.2.c <br /> CONTRACTOR: �U�; � �'%��{,,(��.l�,,� PHONE: ��� --r'r��'_-4���(/1 <br /> CONTACT PERSON: /��,,,�Q MOBILE/PAGER: 9S.? -�rG � ,3�ao °� <br /> MAILING ADDRESS: iG.s'�c3 ,11r�,Q-ti���-p CITY: ,�,�/,�,,�, %�,� ZIP: s�7`o ySi <br /> STATE LICENSE: #�C E X�..f� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure _ <br /> Move Remodel/Alteration_� Land Alteration <br /> PROPOSED WORK (describe in detai�: � - � <br /> _� <br /> STORIES: � SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROONIS: GARAGE STALLS: ATT. DET. <br /> ESTINIATED CONSTRUCTION VALUATION (excluding land): $ d'C ��' <br /> � <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 underst is is not a permit and work is not to start without a <br /> permit; and that the work will be in ccord n ith the approved plan. <br /> APPLICANT'S SIGNATURE:� � DATE: l�- � - G � <br /> NOTE! Parade 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 /> 5 <br />