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-+ CITY OF OR�NO - BIIILDING PER1�iZT APPLICATION <br /> ,�' <br /> �i Fee: $ �/o?. �'/'� � Date Received: ,3- ��` �7 _ <br /> Date Approved: <br /> � Entered By: �,('� permit#;��7 �/� <br /> AT.T. INFORMATION MIIST BE SIIBMITI�D IN FULL BEFORE PLAN REVIBW �TII�L BE STARTED <br /> (See Check-off List Enclosed)� � <br /> -------------------------------------------------------------------------------- <br /> T� APPI,ICANT IS: (circle one) OWNER o�CONTRACTOR <br /> JOB SITE ADDRESS: IISr-�. A�.�►z 5-rQe�r ZIP: �53�,I <br /> (work) <br /> NAI� OF OWNER: �T rIT�ArJDI. GAtZLyG� PHONE: (home) <br /> MAII�ING ADDRESS: I185 Att��� �-�EeT CI�: Da.rrr�o ZIP: ��11 <br /> CONTRACTOR: ���d I.}o�� PHONE: �33-03�2. <br /> MAILING ADDRESS: �-�4D d2'�D /�.rEaae �+o,�r�+ CITY:��,�,,.�yn,,,� Z IP: 5�2� <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration ,� Renovate Land Alteration <br /> PROPOSED WORR (describe in d�tail) : ����.�r�or��� ' _ <br /> STORIESs SQ. FEET OF EACH FLOOR: <br /> NO. OF BSDROOMS: GARAGE STALI.S: ATT. DET. , <br /> BSTIMATED CONSTRQCTION VALIIATION (ezclnding land): $ 10�1��" <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work wil•1 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 thelwork will be in accordance with the approved plan. <br /> • • Jr%2�L1 � DATE: � a'�+ / � <br /> APPLICANT S SIG�1'ORE. �// <br />