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/A L <br /> CITYOFORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ 0�' 0� Date Received: <br /> Date Approved: / <br /> Entered By: ��J Permit#: 61 D <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> --------------------- ------------------------- <br /> THE APPLICANT IS: (circle one) O11NER/-o� �ONTCTOR <br /> JOB SITE ADDRESS: /��O /u / Q cE ZIP: <br /> (work) <br /> PHONE: (home) <br /> NAME OF OWNER: <br /> MAILING ADDRESS: <br /> CITY: ZIP: <br /> ` PHONE: <br /> CONTRACTOR: o ® ' <br /> MAILING ADDRESS: S 8� r� CITY:__, � ZIP: <br /> STATE LICENSE: # qy 3 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: <br /> CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : / <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ <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 will be in accordance with the approved plan. <br /> DATE: <br /> APPLICANT'S SIGNATURE: <br />