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Total Fee: S Date Received: <br /> r Date Approved: <br /> Entered By: M Permit;,`' Zf 3k <br /> CITY OF � RONO - BL-MDLNG PER-)L/11T APPLICATION <br /> ALL INFORMATION`MUST BE SLBNIITTED IN FULL BEFORE PLAN REVIEW WILL <br /> BE STARTED <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> ,IOs SITE <br /> ADDRESS: 42S 01A G ZIP: 5,53 5C, <br /> NA,NIE OF OWNER: HLIC PHONE: (home) A-ko A Ja <br /> 4" (work) <br /> -NVU LING ADDRESS: ..564--d— CITY: ZIP: <br /> SELA ROOFING & REMODELING, INC. p,��( <br /> CONTRACTOR: 4100 EXCELSIOR BLVD. PHONE: Pw-eo4 <br /> ID#0001050 II.E PHO�1E/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # -InEQ <br /> ARCHITECTiENGLN-EER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAINIE: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel Alteration Land Alteration <br /> PROPOSED VORK(describe indetail): keA . rAhVA <br /> Mr <br /> STORIES: _ SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE ST_ULS: ATT. DET. <br /> ESTLMATEDCONSTRUCTION-V_-i-I.UATION(excluding land): S <br /> I hereby apply for a building permit and I acknowledge that the information above is complete <br /> and accurate; that the work will be in conformance with the ordinances and codes of the City <br /> and with the State Building Code; that I understand this is not a permit and work is not to start <br /> without a permit; and that the work i be in cc rd e w' the approved plan. <br /> APPLICANT'S SIGNATURE <br /> DATE: <br /> NOTE.' Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />