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Total Fee: $ ��/ • =� / Date Receive . ,��' �� 7�� <br /> Entered By: J�'/� Permit#: <br /> ,� i 1�r'�c;� ��'.���.% <br /> CITY OF O , ONO - B � DIN PERMIT APPLI <br /> , '�lr %'Y)'1!)�� �� �C%� <br /> � All information must be submitted in full before plan review will be st <br /> 'h � . <br /> ��,�� (please print all information) <br /> ---------------- ----------------------------------- - —=_�-�------------------------ - <br /> ------------------- <br /> �� � TI�E� ANT IS: (circle one OWN� E�OR CONTRACTO �' <br /> :�1 , �� � _ /�/ , � ) ��. <br /> JOB SITE DRESS: SS ��'/� * �/v ZIp: S S .�S y <br /> �;�`��1��' �' <br /> ,, �y NAME OF O R: , ��4N� �C�'�'����� HONE: (home) <br /> % .�7�� �_ /r/ � (work) C�! Z- �'E�7 �'�'�7 <br /> '�i I�IAII..ING ADDRE : �3-S �--`�`�oPr� � Y: �.�� ZIP: s�'�s'Szj <br /> CONTRACTOR: M PHONE P��� � T �°^'� <br /> CONTACT PERSON: MOBILE/PAGER !�+n...�� -�++� <br /> NiAILING ADDRESS: CITY: S y 5�-�',.� <br /> STATE LICENSE: # .�,(c� <br /> �U. <br /> ARCHITECT/ENGINEER: PHONI.'��'P'�'� � "�-�`� <br /> NIAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF `VORK: New Ad 'tion Accessory Structure <br /> Move Remodel/A1 ration_� Land Alteration <br /> PROPOSED WO describe in detai�: T�.e s f ����N4 t 5 a r ���w�Nf <br /> r �N�°�'t l �N�; �+- <br /> STORIES: SQ. FEET OF EACH OOR: N� <br /> NO. BE OOMS: �'� GARAGE STAL : ATT. �-- DET. <br /> ESTIMATED CONSTRUCTION VALUATION (exclu ' land): $ ���J <br /> I hereby apply for a building permit and I acknowledge that the � ormation above is complete and <br /> accurate; that the work will be in conformance with the ordinances d codes of the City and with <br /> the State Building Code; that I understand this is not a pernut and rk is not to start without a <br /> permit; and that the work will be in cor ce wi the pproved pl . <br /> Y <br /> APPLICANT'S SIGNATURE: �� � DATE: /" I�S l Z� <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Counci160 days prior to the event. Non permitted events will not be allowed. <br />