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Building Permit Application U zz <br /> e e i E D Date Received: c'I✓' <br /> Permit#: ((54,4' e I'l,'`;V 1 <br /> Reason(s) for denial: ' --n C) (-‘r— 912-nraV Atic�nit11- <br /> iv bra is— / ILA s - • ' • • - BUILDING PERMIT APPLICATION <br /> 3. /fit le item n d s Cv✓r'/ u <br /> % se-�c�rrhi- <br /> Staff: 1 74 inforr> �n'nust be submitted in full before plan review will be arted. <br /> L/L'G ''(please print all information) <br /> 4 <br /> THE APPLICANT IS: (circle one) OWNER O' CONTRA OR <br /> JOB SITE ADDRESS: /Q /% r,) iti e_ .• IP: $ <br /> Will this begrade of Homes, 11‘ ,,modelersShowcase Ho •e or other Display Home? <br /> gYes No Ifyes, a special eve+t permit is required with P,lice Department and CityCouncil approval <br /> 60 days prior to the a ent. Shuttle bus service ill be required unless applicant demonstrates <br /> sufficient on-site park ig is available. No permitted events will not be allowed. <br /> NAME OF OWNER: Free, ,)tire . O r\ PHONE: (home)0L1 701 <br /> (work) <br /> MAILING ADDRESS: 7?3 i co eA CITY: ZIP: r� .,5.,L <br /> CONTRACTOR: /) lC, 4 04 t eA PHON L1 S –F 5? /57 <br /> CONTACT PERS N: /I7 ` MOBILE/PAGER: ( t. <br /> MAILING ADDRESS: ./7crc //-/c;, ,/Z-un LCL CITY: /J//c,,,,,,J__ ZIP: c5'34, c/ <br /> STATE LICENSE: #,2cti:3-/6,7'( _ PIRATION DATE: 3 -- 31 .y0.3 <br /> ARCHITECT/ENGINEER: go giftSj$ ` PHONE:'9)? YL / ff f'Y <br /> MAILING ADDRESS: 41,-T S"„ d„....(.r )2- cITY$(r / ZIP: <br /> NAME: f" REGISTRATI -ON: # fj>7 .7i.. <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteratiot (ie: Siding, Windows) <br /> Any earth movement may require WD review and permits ! <br /> PROPOSED WORK(describe in detail): PO0 K A-c er. 8,. <br /> ,J- ,f i"t"irs (L7 c.“-05e-- '�t�ctih4. -- t", re-C- <br /> STORIES: 7 SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: / GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 4. '� <br /> I hereby apply for a building permit and I acknowledge that the information above is comp•te and accurate; <br /> that the work will be An conformance with the ordinances and codes of the City and with the tate Building <br /> Code;that I understand this is not a permit and work is .F t. .tart without a permit;and that the ork will be <br /> in accordance with t$e approved plan. <br /> hi <br /> APPLICANT'S SIGNATURFr DATE: 70 C7 <br /> 31 <br />