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CITY OF ORC:IO - BUILDING PERMIT APPLICATION <br /> 'otal Fee: $ 4/6-• 6'Z'' (4� 6" -/ l a ) ) Date Received: <br /> Date Approved: /O1,2 / 2•— <br /> ::Ztered By: iri,/ <br /> Permit : � '/'`) <br /> D.L INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> IB APPLICANT IS: (circle one ) OWNER o NTRACT <br /> •7B SITE ADDRESS: C) C,- J/,.j),7",-Fr',•E 1-r" /c'/. <br /> ZIP: <br /> (work) <br /> ----- PHONE: (home) <br /> AME OF OWNER: I ca -0 Lae/'`-1 , <br /> :AILING ADDRESS: CITY: ZIP: <br /> N <br /> ;ONTRACTOR: ��4 zc-i e S, r"`> PHONE: •/ / 7'4.7).4/ <br /> / <br /> SLING ADDRESS: 37'e-6 £ �Gl`Q � ('p�e CITY: OrbnJ� ZIP: 6 �6i <br /> :TATE LICENSE: T li sC) <br /> ,RCHITECT/- t. •f- - - : PHONE: CITY t OF i 0,1,G <br /> n_•rrrr <br /> FINANCE ut t 24L <br /> AILING ADDRESS: CITY: ZIPS+ j(`{1{jfJ rr <br /> 01 'viii{ 45.0 <br /> REGISTRATION # ;-' -; ;':tiny, ,+ <br /> :i::duv n <br /> .L LL t.till <br /> VV <br /> •••Lrrr•r t .4 i -i <br /> 1..•t tL L•!1 /L TV.YV <br /> 'PE OF WORK: New Addition Accessory Structure MIo •r: ;,!...:NIN riv <br /> rsr_4r.sr-i---z NINA t u� <br /> Demo Remodel/Alteration L-,---- <br /> ,- Renovate Land Alterat.1s, =';; riv)1 jj V1 115:41' <br /> ?fr: !L <br /> tY! VL7/ d. <br /> ROPOSED WORK (describe in <br /> detail) : P-c, c--- V <br /> _'ORIES: SQ. FEET OF EACH FLOOR: <br /> -'7. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> >TIMATED CONSTRUCTION VALUATION (excluding land) : $ '' oC <br /> hereby apply for a building permit and I acknowledge that the information <br /> eve is complete and accurate; that the work will be in conformance with the <br /> •dinances and codes of the City and with the State Building Code; that I <br /> derstand this is not a permit and work is not to start without a permit; and <br /> at the work will be in accordance with the approved plan. <br /> 'PLICANT'S SIGNATURE: GG <br /> DATE: /,t5)`. �� <br />