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Building Permit Application <br /> 11 723 <br /> Total Fee: DENIED <br /> Date Received: C P <br /> Entered ra , , , Ate/ Permit#: <br /> O'! 4 <br /> F O�ONO - BUILDING PERMIT APPLICATION <br /> Staff: Oa�e: bi <br /> G <br /> All in orma ion mus t e su m 11 Defore plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER E.2. CONTRACTOR <br /> JOB SITE ADDRESS: 9D / ,t)o £/-/ ji21 CJ E- ZIP: <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 required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. Non permitted events will not be allowed. <br /> NAME OF OWNER: , PHONE: `L <br /> 7`3- 7136-5-606 <br /> (work) <br /> MAILING ADDRESS: E CITY: ZIP: <br /> CONTRACTOR: P b2-Sc,,J 7,ot.1 t- c PHONE: `l l- r 3 3-30 t o <br /> CONTACT PERSON: $c,o 7-r- >2._ MOBILE/PAGER: h Z-zzt - <br /> MAILING ADDRESS: 13 I O f?w0 CITY: gg ,..„,,,,e1-6,01e.4.ZIP: /j <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure JL <br /> Move Home Remodel/Alteration (ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits ! <br /> PROPOSED WORK(describe in detail): (tis ; n V 1,1 L <br /> ift,ucn ?0c Zo 1.,c4 <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> t .400 0-D <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ` � -7 <br /> I hereby apply for a building permit and I acknowledge 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 is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: I DATE: q/11 /5 7 <br /> .1 <br /> 31 <br />