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Total Fee: S <br />Entered 3y: <br />CITY OF ORONU “ /i-L'jt'OjxL-rt-lxuh <br />Cate Received: <br />Date Aonroved: <br />Permit #: <br />ALL INFORMATION MUST BE SUBMITTED IN FULL BEFO^ P^^ REVIEW WILL BE STARTED <br />(See Check-off List Enclosed) <br />the APPLICA2TP IS: (circle one) /^0WNER^-<5r CONTRACTOR <br />JOB SITE ADDRESS:ZIP: 6*r3‘f/ <br />NAME OF OWNER: <br />MAILING ADDRESS oa 11 <br />(•. ’ork) Q H f (:>(=, <br />PHONE: (heme) <br />CITY:[AjfitU 1^'fA _____ ZIP:_6^^39_/____ <br />CONTRACTOR: <br />MAILING ADDRESS: <br />?TATE LICENSE: # <br />PHONE <br />CITY:ZIP; <br />ARCHITECT/ENGINEER: <br />MAILING ADDRESS:____ <br />NAME: <br />TYPE OF WORK: New__V <br />Demo V <br />Addition <br />Remodel/Alter ation <br />PHONE: <br />CITY:ZIP; <br />REGISTRATION # <br />lire MoveAccessory Struc _ _ <br />Renovate Land AlteratJLcn <br />PROPOSED WORK (describe in det.all); (S^.<W6£ . <br />i C.QU Sv {o OJ>o !to A>-T-r?.CHrg /g>X>4 <br />STORIES:SQ. FEET OF EACH FLOOR: <br />JO. OF BEDROOMS;GARAGE STALLS; ATT.DET. <br />TGoo a<o> <br />:STIMATED CONSTRUCTION VALwATION (ejccluding land): $ <br />4 <br />■ hereby aoply for a buildincr permit and I acknowledge that the <br />:bove is complete and accurate; that the work will be in conformance wr^h ^he <br />ordinances and codes of the City and with the State Building Coae; /tna<- x <br />inderstand this is not a permit and work is not to start without a permit; an <br />.hat the work will be in accordance with the approved plan. <br />PPLICANT DATE 'A