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� F pRONO - BIIILDING PERMIT APPLICATION <br /> CITY O � <br /> i ��-" <br /> ,� � Date Received:,� ' fu " % <br /> Total Fee: $ ��� �\ <br /> Date P.pproved: <br /> . r ' <br /> �ntered By: Permit Q: %.=3 � 7 <br /> AI.L INFORMATION MIIST B$ SUBMITTL�D IN FIILI' 8��� p�N �I� ��'�' BB STAR�F� <br /> (See Check-aff List Enclosed) _________________ <br /> -----------�-�- T <br /> � AppLI�A�7� IS: ( circle cne) OWNER or CONTRAC_OR <br /> . ,_. '` -7 v�c:'2���5�'�(���- � '"L--� ZIP: <br /> JOB SITE ADDRSSS: � ' � <br /> (work) <br /> � � - � ��j���� PHONE: (home) <br /> N�ME OF OWNEK: � -' <br /> � ��� ��t �� CITY: ��f2-ii'--'(� ZSP: � S ���_�_____ <br /> MATLING ADDRESS: �- (� �� �SG��.� -_s� <br /> ��-� -���� <br /> CONTRACTOFt: ����T�L:.' � '`�''•'`�' PHON$: <br /> . 2.���> /�J��6� � L;� cz�: � � ���'���/ zzP: ���(�—, <br /> ?�ATI,ING ADDRESS. <br /> STATS LICENSE: � `rt �� ` <br /> PHONE: <br /> ARCHITECT/ENGZNEERs <br /> CITY: Z2P: <br /> MATLING ADDR$SS- <br /> R.BGISTRATIOA u <br /> N�: <br /> TYPE OF WORR: New <br /> Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> �f�`�j� �3 �'��, <br /> PROPOSED WORK (describe in detail) : � <br /> STORIBS: SQ. FEBT OF EACH �LOOR: <br /> NO. OF BSDROOMS' ��� STI�LLS: ATT. DET. <br /> � ( � Ooo <br /> ESTIMATED CONSTRIICTION VALIIATIoN (eacl}lding Iand) = $ � <br /> : hereby apply for a buil.ding pe�i the work ill be in conf rmanc£�"�lthtth. <br /> above is complete and accurate; that that <br /> ordinances and codes of the City and with the State Building Co e=�it; an� <br /> understand this is not a permit and work is not to start without a p <br /> that the work will be in �cordance with the approved plan. . C � <br /> , ,, � ���°-�� <br /> : , . (,., <br /> ; ___..-_ _ <br /> � ���%�� DATE: <br /> APPZICANT'S SIGNA�URE: <br />