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� <br /> CITY OF OROI�s�UII�DING PERMIT APPLICATION <br /> Total Fee: $ Date Received: 3 �� 3 - 9 a. <br /> Date Approved:�- � c1 Z cE <br /> Entered By: <br /> Permit#: ��� �� <br /> AT•T• INFORMATION MDST BE SIIBMITTED IN FIILL BEFORE PI,AN REVIEW WILL B$ STARTED <br /> (See Check-off List Enclosed) <br /> THE APPLICANT IS: (circle one) OWNER CONTRACTOR <br /> JOB SITE ADDR$SS: ;��y� S`ji>��� �llYrt� ZIp; ��/G� <br /> (work) ��/"%��-�� <br /> NAME OF OWNER: � -l'� �(/ ; PHONE: (home) /� � <br /> MAILING ADDR.ESS: ��/� ��'/X ca?� CITY: /�;��,�'/',1'� ZIP: _�-�� <br /> CONTRACTOR: • /'1/� � PH��= <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHI TECT/ENGINEER: �'H��= <br /> MAII,ING ADDRESS: CITY: ZIP: <br /> NAME: R.EGISTRATION # <br /> TYPE OF WORR: New Addition Accessor Structure Move <br /> Demo Remodel/Alteration Renovate� Land Alteration <br /> � � <br /> PROpOSED WORR (describe in detail) : �-�-� ��,--�-;�� <br /> --- �./ <br /> _7 J �� /�C`� /� <br /> c� ��� i� ' zx 9 <br /> IE : S . FEET OF EACH FLOOR: � <br /> STOR S Q <br /> NO. OF BBDROOMS: GARAGE STALLS: ATT. DET. � <br /> � , � p-c,�,,, r -1-- <br /> ESTIMATED CONSTRDCTION VALIIATION (egcluding land) : $ ��� � P`� ��L� <br /> I hereby apply 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 /> that the work wil 1 be in accordance with the approved plan. <br /> � <br /> _... ___ _ , <br /> APPLICANT'S SIGNAT6i2�:---- ��' DATE: 5���--- <br />