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. _� �' ,� , <br /> Total Fee: $ �,/(�,% . ���� ������ ;L�� ' � Date Received: ��'���� <br /> Entered By: .¢�'(� r ;. , Permit#: �'� / ,,"�./�� <br /> �� ���7')( (� ,��i"L � <br /> CITY OF C�RONO - BUILDING PERMIT APPLICATION _�,_,�,�� <br /> All information must be submitted in full before plan review will be started. � <br /> (please print all information) <br /> ------------------------------------------------------ ----- -�------------------------------------------------------ <br /> THE APPLICANT IS: (circle orte) OWN R OR CONTRACTOR <br /> JOB SITE ADDRESS: :-�-�'c��=' ��-'a�`��-- L�����.- ZIP: �rs 3 cl� <br /> _> � <br /> . <br /> NAME OF OWNER: I, a.=1-� � �-S C�-t�Z ` PHONE: (home) q Sa-�t/�7�~l D�, <br /> (u�nrltl (G'-� � � 7C'� `.C,1^ !..�� <br /> �.:..---� <br /> MAILINGADDRESS: ,���,� rl�avR4r�. CITY: � ��Or�v ZIP: �"S" �'�/ <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <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 /> � <br /> PROPOSED WORK(describe in detai�: ��C(c�� S�� �C ✓ �� ��t��- ' P �,���oW <br /> — — —�— — _��� <br /> �� <br /> � <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �p�0 <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 understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in a ance th the approved plan. <br /> .�� , <br /> APPLICANT'S SIGNATURE: a� � �;-- `_--�G� DATE: � <br /> 2 <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 />