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` C;c�% . �— <br /> Total Fee: $ i / ' ��' Date Received: `� '�L�' (�j7 <br /> � Entered By: i=�,�'�. -� Permit#: � �}�,� i 7� <br /> -� � <br /> �ir�"�' y�` /:.�'l ��J _; <br /> CITY OF ORCSNO - BUILDING PERNIIT APPLICATIOl� <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT I5: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: r�[�1 ,� S/fA�J i>!.v n��►� �� ZIP: $�S"3 «/ <br /> NAME OF OWNER: �J L�,�;,. C� K��� ��� PHONE: (home) �%5�--�/7/ i/9 0 <br /> (work) �J��-�� -3� c � <br /> MAILING ADDRESS: ��l� S hS��wE��� /Z J CITY: �, ZIP: s'13 �� <br /> CONTRACTOR: G-I� S �'vs�G,v � ,l�U� L c� PHONE: (��� 'to/6 --�-G / (� �e� <br /> CONTACT PERSON: ���L s�-�v� r%t MOBILE/PAGER: <br /> MAILING ADDRESS: ;).1� u,-�.,,�i-n�c,y.r .s�r. CITY: (,�, �—G GN/�F' ZIP: S" -3�� <br /> STATE LICENSE: # �;o o )7 S�}- <br /> ARCHITECT/ENGINEER: �!-7,S PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME; REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteratio�� Land Alteration <br /> PROPOSED WORK(describe in detain: I��Pt..r}C r �/ ��,,,���o�:, s ,¢� r� <br /> y� o ✓� s rai;�S r� <�.��2 z.;���.�� <br /> STORIES: l SQ. FEET OF EACH FLOOR: �4 P�c�� /:��'>�' S� ��.� F��..,� <br /> NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. x DET. <br /> ��. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��'� � <br /> I hereby apply for a building permit and I acknowledge that the information above is con7plete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the Ciry and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: � DATE: �1-I�' -��� <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 />