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• ._� <br /> .....—= � <br /> 8uild�ng Permit Application �t �d � <br /> ,/_ � <br /> . D�1�' Date Received: 'T 23"�� <br /> Entered By: Permit#: A/09'/.3 ,� <br /> �Reason(s) for�nial:_ � <br /> I <br /> � r NO -BUILDING PERMIT APPLICATION ; <br /> , ,l- �s�`' i <br /> Staft:._�.,._._::: �e submitted in full before plan review will be started. <br /> (please print all information) <br /> � <br /> _ I <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: / t� ZIP: 5��,3 g/ <br /> � Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑Yes ❑NO If yes,a special event permit is reguired with Police Department and City Council approval <br /> � 60 days prior to dhe event. Shuttle bus service will be required unless applicant demonstrates <br /> � d su�cient on-site parking is available. Non permitted events will not be allowed. i <br /> i � NAME OF OWNER:J�,� q�.JA�,�e�ve / lY0/1/�PHONE: (home) <br /> � � �W�� <br /> � MAILING ADDRESS:3/� /�,7a2 s�i fl/2 t �CITY: ZIP: ,�—S�/ � <br /> � CONTRACTOR: PHONE: — �—�/T' (� <br /> CONTACT PERSO • u �BILE/PAGER: 1, _ O a� <br /> � � MAILING ADDRESS: crrY: z�: ..s-s � <br /> � STATE LICENSE: # EXPIRATION ATE: <br /> � <br /> � ARCHITECT/ENGINEER:��j •�Z +J�PHONE: (o f�v��I -7S�S <br /> � MAILING DRESS• CI : �� ZIP: l��,S' <br /> �0 NAME: a REGISTRATION: # <br /> Q <br /> y TYPE OF WORK: New Home � Addition Accessory Structure <br /> � IViove Home RemodeUAlteration(ie: Siding,Windows) <br /> . � Any earth movement may require MCWD review and permi�s! <br /> ` � PROPOSED WORK(describe in detai�: <br /> � i <br /> � � <br /> '• STORIES: �_ SQ.FEET OF EACH FLOOR:�S/1��7`'/S�� / S�/.s'.5� o� ����� <br /> : � N O. O F B E D R O O M S: � G A R A G E S T A L L S: A T T A C H E D� D E T A C H E D_ <br /> � � ESTIMATED CONSTRUCTION VALUATION(excluding lanii�: $�T�. � <br /> s '�E �' <br /> I hereby apply for a building permit and I acl�owledge that the information above is complete and accurate; � <br /> that the work 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 i t to start without a permit;and that the work will be <br /> in accordance with the approved plan. ` / � <br /> , , � � <br /> APPLICANT S SIGN DATE: ����.� <br /> . # <br /> a <br /> a. � 31 ' # <br /> ' � <br />