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� ,, CITY OF O,�tONO - BIIILDING PSRMIT APPLICATION <br /> Total Fee: $ !�, � � SJ , � �J Date Received: �-��� �o <br /> —T <br /> Date Approved: <br /> Entered By: <br /> Permit#: ��� � <br /> AT•T• INFORMATION MIIST BE SIIBMITTED IN FIILL BEF'ORE PLAN REVIS'W WILL B$ STARTED <br /> (See Check-off List Enclosed) <br /> ----------------------------------------- ------------ ----------------------- <br /> -�- <br /> THE APPLICANT IS: (circle one ) OWNER o CONTRACTOR � <br /> JOB SITS ADDR$SS: ����� _� �;:>'�`t�- �-����''y,l:� � ZIP: s'5��� <br /> `� � - <br /> �} �C1C:K�� j:.t., e�«c4t.--�f� <br /> i ,� (work) <br /> NAME OF OWNER: PHONE: (home) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: S ,tJl�.f• I+� _�. �i -. I ,�. PHONE: � 7> >> �J � <br /> r <br /> MAILING ADDRESS: S�I�U' -�% i,�_'= �� CITY: �1C `�cC�C'� ZIP: �� ���� <br /> TYPE OF WORK: New � Addition Accessory Structure Move <br /> Demo Remode�/Alteration Renovate Land Alteration <br /> PROPOSED WORR (describe in detail).: �'� r � ��C���� <br /> STORIES: �� SQ. FEET OF EACH FLOOR: � `;I =.�� ��% -�^L� -��`�_� <br /> NO. OF BEDROOMS: �`�— GARAGE STAI.LS: ATT. � DET. <br /> � <br /> ESTIMATED CONSTRIICTION VALIIATION (egcluding land) : $ � �7,) L��.�c:� �� <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; tk�at I <br /> understand this is not a permit and work is not to start without a permite and <br /> that the work wil 1 be in accordance with the approved plan. <br /> C'� _ �� � � � � ;, � <br /> APPLICANT'S SIGNATUI2E:��3}r-�� ( ;' . ���..- "_ DATE: �] �r=��3-��'� <br />