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, � ���� <br /> Buildirsg S�$rm�t Appi��atior� M�,� <br /> r t� • � Date Received: B`/6"D � <br /> .:ntered y: Permit#: fJ� <br /> Reas�n(,$) for d$nial: _ <br /> - BUILDING PERMIT APPLICATION <br /> 5�2 ,a�c.iC.- i s��� -� s-��i z l <br /> Steff �_ All infop���ioi���i�s�be submitted in full before pla� review will be started � <br /> (p[ease print all information) <br /> -------------------------------------------- ---------------------------------------------------------- --�� --------- <br /> -- �__.,__ � <br /> THE APPLICANT IS: (circle one) QWNER 4R CONTRACTOR <br /> JOB SITE ADDRESS: L Z `�� L� 1c:� ...`�,,�. ,!�- � �. ,� ��. � . � � � `� I <br /> Will this be a Parade of Homes, Remodelers Showcase Home or ot er Display Home? <br /> ❑ Yes �NO If yes, a special event permit is reyuired with Police Dep rtment and City Council approval <br /> 60 davs prior to the event. Shuttle bus service will be�•e ui��ed unless applicant demonstrates <br /> sirfficient on-site parking is available. �ti"on-permitted events will not be allotived <br /> ,. <br /> NAME OF OWNER: I�- � �t;,, 1 \i � � � PHONE: (home) `��L y l 1 I 6�v <br /> (work) '�i��- 2, 1 0 �3Zs <br /> MAILING ADDRESS,f 1 L ��i �..,�-w,c..-�-r-��. CITY: �v,..�, 1-y�', ZIP: �.i 3 i, <br /> 1 <br /> CONTRACTOR: �`, �(� � ����� (� �,r� z� PHONE: `"j s Z 7' �i I � � � <br /> CONTACT PERSON: ���. MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: �.,,, �� - �,'_ PHONE: `i� z `-3 3 �i � y y�� <br /> MAILING ADDRESS: ;� C \,.� � � `-� �} CITY: C�.; _�.,,;. __ ZIP: 5.l .3 ► 7 <br /> I�'AME: ' REGISTRATION: # <br /> TYPE OF WORK: New Ho Addition � Accessory Structure <br /> Move me Remodel/Alteration (ie: Siding, Windows) <br /> Ar.y arth movement may require MCWD review and permits ! <br /> PROPOS D WORK de ribe in detai a;-� �,. _ . � ��^' � <br /> ( �: �-t�:�� -�-� ��>.�� �-� <br /> � � �C �i -�-- <br /> � <br /> STORIES: � � SQ.FEET OF EACH FLOOR: �1 �`t 0 <br /> NO. OF BEDROOMS: �' GARAGE STALLS: ATTACHED�_ DETACHED_ <br /> ESTIMATED C�ONSTRUCTION VALUATION(escluding land): � �"� (�J , ��0 _ �� <br /> , <br /> I hereby apply for a buifding 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[ 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 /> L �'�����-�-�, ./ <br /> i' <br /> APPLICANT'S SIGNATtiRE: �� e--G-L"' -� " DATE: �� " �C� (. �7 <br /> 31 <br />