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So�-28-2005 ll:di�m Frcm—CITY OF O�ONO J^�� +9:i2494616 T-697 P.O10/034 F-427 <br /> � y,. �� ,�� -� �-- <br /> -, � , ���� fi <br /> Tc�tat Fee: $ ��� � 1� � � �� _ 1 Datt Rcccived: � L/C����� <br /> Entered By: ` l.-' „ � ' 1'ermit �i: � <br /> �CITY O�' 4RONQ � BCTILDYNG� PE��T APPLICA.TION� <br /> Al1 informatiun mvst be submitted in full before plan review wil] be started. <br /> (please print all inforn'�ation) <br /> THE ApPLXCANT IS:^ (circle one) OWNER OR CONT�ACTOR <br /> �oa si� �nnrr�ss: 31tis Nor+}.S�� D�. ,zrn: Ss�9/ <br /> rr�bF a�c�tv��: ���er-s�,Se�« �Si•o-r�� r�orr�; (hame) 9S� q�7-/��S <br /> (work) <br /> MAILL�'�TC A.DDRESS: /S9� F� ��l�.T.CI�d Pr��c CYT'Y:�dcn Pra.;�« ZIP: SS�S/7 <br /> COI�"d'RACTOR: �+e. Qov,�r�ar�S+ruc.�i on�Tnc• ---PHC}1V�: 9Si y7�/-$�7 7 <br /> CONTACT PERSON: f�-k� tio4� MOBIL.EIpA�ER: ,L�i 308-/97 y.__ <br /> �'YATLL�'ts ADDRESS:j�I G$S �xG�-f,Si•� (3fud. CYTY:�xc�l si o,r- ZT�':�'.331 <br /> STATE T.ICENSE: � //L o <br /> FOrMa�`i o� �rG�i'1cGf'S <br /> ARCF�ITECT/ENGTNEER: �i M 1'�c 1Jto�\ @ PHDiV�: 6�•Z�331-'�/9`10 <br /> MAILIN�AD�.l�S�: �7s �'�o-�kct Sf..51r.�`�`�7_CITY:/'�,�ta�. 01_i�ZIE: SS�/oS <br /> NA1��E: — —R�G�STYtATIpN# <br /> TY1'�QF VV�RK_ New X Addition Accessory S[ructure <br /> h�ove �'�emodcl!Altcraiion Land Alteration <br /> �'ROP�SED WO�i(describe in detai�: �� do.y� rac�'st���, /�.�,rie r b���d ��,.s <br /> b� „So�.r.a- si�. �_� <br /> � �To�s: a �Q.F�.�T OF EACH F1,OOR: <br /> NQ. (}� BED�OQMS: _ GaRAGE STALLS: ATT. DET. <br /> �STL11�iATED CCJtiST�tUCTION VALY3ATION(exctuding Iand): $� ,��f,2�C' - <br /> 1 her�by�apply for�building permit and I acknowledoe that khc information above is complete and <br /> accurate; ahat the work will be in confo:mance wi�h the ordinances and codes of the City and with <br /> the St�te Buildir.g Code; that T understand this is not a permic and work is noc co start wi�haut a <br /> pern�it; and tY►ac the wark witi be in acco nce wit the approved�ian. <br /> , ,/1 � <br /> � — <br /> APF'TlYf:'A.�IT'S SIGNAI"URE: �--� '� ' ��- ��.�(.�r1ATE:_ �� � �� -- <br /> i ; <br /> ,. ; : <br /> NOTEI Para�`�� events require sepay'ate pe tit approva!by Police Deparfi�e►tt and <br /> City Cor�ncll 6a days pr7or to the event. Non permitted events will no! be allon�ed. <br /> A <br />