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May 18 07 11 : 36a DreamMaker 9524179083 p. l <br /> ti - <br /> (/ � � <br /> Tatal Fee: S -�b�' ZS Dabe Received: C � I � <br /> Eo1�et�ed By: J Z--Z Permit#: r� I I � ( � <br /> �� � <br /> CYTY OF O�iONO- BUILDING PERMIT APPLICATION <br /> Atl iaformation must be submitted in full befvre plan rcview will be�tarted. <br /> (pleurse pri►if a�ll rn}�ormation) <br /> THE APPLICANT YS: (clrcle one) OWNER O CONTRACTOR <br /> �OH SITE ADDRF,SS:��-.�/C(�U/�-J 1�L-/C1E ZIP: .���J' / / <br /> Will this t�a P de of Hamea,Remodeler� Showcaae Hnme or other Display Home? <br /> ❑ Yes N� Ifyes,a sJ�ecJol event pernrit i,required with Polic�nepwlmentund Ciry Cvun�il approval <br /> 6Pdays privr to l��e�ve�[ 5'huttte bu9 service will hr.reguired unlr.as appliemitdemr�,,strqdas <br /> svfficieRt on-sile parking is avail�ibla, Non pernritted events will not he ullawed <br /> NAME O.F OWNER: �Ll L�C� PHONE: (home) 9g�"' y'J� • ��8� <br /> � p� (wodc) <br /> 1VI.A�LING ADDRCSS: 2�� "�r�7EV LI 1� _C1TY: (�If�C�ll.l D ZIP: 53 / <br /> COI�i'I'RACTOR: r L�/� PHONE:9S� �Il ��? cj <br /> CONTACTPERSON: Ec7�`c2 MOB�LE/PAGER: 9 a- .57�j <br /> MAILING ADDR�SS: U 41 1.�5�►-�,1 7/� CTTY: �SL.� : �5�/>--� <br /> STATE LICENSE: �t�Q?,�j�jQS EXPY'RATION DATE: / O <br /> ARCHITECT/ENGINEER: PHONE: <br /> MA�LING ADDRESS: Cl'Y'y; Z�p; <br /> NAME: REGTSTRATION: # <br /> TYPE OF WORK: New Home Addiiion Accessory Structute <br /> Move Home Remodel/Alteratioa(ie: Siding,'Windows) �� <br /> Any earth movement may require MCWD rev'ew and permitsl <br /> PROPOSED'WORK(Qescribe la ai�: .S / �p ,r./�t <br /> v O��- — �c�E a air� — 5 F/L N <br /> STORIES: �� SQ.FEET O�'EACH FLOOR: <br /> NO.OF BEDROOMS:y� CARAGE STALL5: ATTACHED DETACHED <br /> ESTiMA'�'ED CONSTRUC'I'�ON VA�.UATION(excluc�ing land): $ ��, Q U C� <br /> I hcrcby apply for a building permit and I acknowledge thal the information abovc is complete and aocutate; <br /> that�he work will be itt conformance with che o.tdinances and cades of the City and with the State Building <br /> Code;tha�1 undrrstand this ie not a permi�an,d work is not tn Cart without a permit;and lhat the work will be <br /> in accordance with the approved pl _ <br /> APPLICANT'S SYCNATU : �� GG�DATE: I� �� <br /> 31 <br />