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CITY OF OROi+10 - BUILDING PERMIT APPLICATION <br /> Total Fee: $y-��� �% `�-� Date Received: ''� � �� <br /> Date Approved: <br /> Entered By:�.(`��� <br /> Permit�: '�,yC, 7� <br /> AT•T• INFORMATION MDST B$ SIIBMITTED IN FIILL BEFORE PLAN REVIEW WII,L B$ STARTED <br /> (See Check-off List Enclosed) <br /> THE APPLICANT IS: (circle one) OWNER o ONTRACTO <br /> JOB SITE ADDRBSS: �'SGS �lyS/�L� ��� ZIP: SS-�S� <br /> (work) <br /> N� oF owriEx: ,�CT��C �E/✓N�'���''� PHor�: (home) �7a- 73G9 <br /> MAILING ADDRESS: �`5� �����1�� ��� CITY: O�oNo ZIP: SS.3S� <br /> CONTRACTOR: O���N�r1 �oOC 4 /�/�l7(J PHONE: S`�.2 9�A0 <br /> MAILING ADDRESS: 3��s 'y'�'� /G9 tio CITY: ��'`�`o�� ZIP: SS`��`/ <br /> STATE LICENSE: # ��� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> p�y: REGISTRATION # <br /> TYPE OF WORR: New x Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : `L�N��� l� /h�"�� �„�� L��"� 's�~'�`� �'D L <br /> STORIES: SQ. FEBT OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> � <br /> ESTIMATED CONSTRIICTION VALIIATION (egcluding 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 accor nce with the approved plan. � <br /> APPI,ICANT'S SIGNATORE: ` DATE: 3-�'� 9a <br />