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CITY OF ORONG - BUILDING PERMIT APPLICATION <br /> Tot�l Fee: $ ' Date P.eceived: <br /> Date Approved: <br /> Entered By: � ,�� <br /> Permit�: ��3 � <br /> ar•r• INFORMATION MIIST B$ SIIBMITT$D IN FUI�L BEFORE PLAN REVIEW WILL B$ STARTF•D <br /> (See Check-off List Encl.osed) <br /> THE APPLICANT IS: (circle one) OWNE r CONTRACTOR <br /> Jos sz� AnDxsss: a 3o�J ���y�a�o �� zzP: SS'3�/ <br /> ! �s <br /> (work)q'2/-� <br /> N�ME OF OWATER: /�.�0�"t� iV �� PHONE: (home) �rJ/`�gb7 <br /> MATI�ING ADDRESS: � 30� S��R-� GtlD a� � CITY:�/Q��f'�} ZIP: ���Q/ <br /> CONTRACTOR: PH��`T�= <br /> �it,ILING ADDRESS: CITY: ZIP: <br /> STATS LICENSE: � <br /> .ARCHITECT/ENGINEER: PHONE: _-- <br /> �SAIZING ADDR.BSS: CITY: ZIP: <br /> �A�: RBGIST'RATION � <br /> TYPE OF WORK: New � Addition Accessory Structure <br /> � Move <br /> Demo�, Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : ���Mo�E�o �Lu I S-F iN C �Rft�� . ' � ' <br /> ,r-1._ ;. � � �' + . '� ; {� i' - ; ' ' ', � ; • �0� 14, <br /> STORISS: SQ. FEBT OF EACH FI,OOR: �1� _ � , �- )r�-/3-`�� <br /> . :� _ _ . .> . <br /> :30_ OF B$DROOMS: GARAG$ STI�LLS: ATT. DET. � 1--' '' <br /> �'� �ve� <br /> - �� ^ <br /> ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ <br /> = hereby apnly for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> �hat the work will be in accordance with the approved plan. • <br /> (� ` ti �' �l 4 z--- <br /> .?PLICANT'S SIGNATDRE -yc�'t��r',X T_ DP.TE: <br /> u <br /> �. <br /> � <br />