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15 <br /> Total Fee: $ .g3 C (70 S�Uate Received: <br /> Entered By: ! I Permit#: /Z Z %e <br /> . 5)l �Tsk eou 7 n L I I I< <br /> CITY OF ORO O - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) • <br /> THE APPLICANT IS: (circle one) ri : CO y CT• <br /> JOB SITE ADDRESS: 1/5-- 4/04 ,g 7 ZIP: <br /> NAME OF OWNER: J/NK /-f,-',a S A-I) PHONE: (home) ? - 5/7 3-17/5s— <br /> (work) <br /> —17y5S— <br /> (work) "m <br /> MAILING ADDRESS: S O CvV t.t/ rrii1- CITY: U/ ZIP: <br /> CONTRACTOR• PHONE: `V' <br /> CONTACT PERSON: -7rzsht) Sou,.t MOBILE/PAGER: 7G.3.- 6r76-- gfSoZ <br /> MAILING ADDRESS: 572.2-a% � S.„, CITY: Ft6 L/cf-t e ' ZIP:„clEka, <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detail): C,4Z6-I3o - Fr,vr '-, OFF ( ib(1 <br /> • <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 above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNAT L,1 DATE: 7— 2 7 --dj <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />