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� Total Fee: $ �/5, � � Date Received: ��J� �%� <br /> Ent�red By: � Permit#: �r;N(�� 1 <br /> �I � � <br /> .� ,i�-: <br /> � ( C I T Y O F O R O N O - B U II.,D IN G P E R M I T A P P L I C A T I O N <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICAI�IT IS: (circle one) OWi�tER O ONTRACTOR <br /> JOB SIT'E ADDRESS: 25 S ��,�-�-� C�z��•.:-�s �.��-c� ZIP: �53�(. <br /> NA.'�IE OF OWNER: �c�v y LUs; PHONE: (home) �2. A-7.3 -5`�57 <br /> . (work) <br /> MAILING ADDRESS: �55 So. '���:_..,-�; �+Z� CITY: �j�,�:.�,;,� ZIP: ��3 5�- <br /> CO\�'RACTOR: ��I r_Q��,w Lo�;,�,�zu�-7-rv-:, (,v PH01�'E: �3 1���-�3b � <br /> CO\�'ACTPERSON.��„_;,,;;,s;j'A���,�. NIOBILE/PAGER: ��Z �3�t, -�1 t4 <br /> MAII.INGADDRESS: >77�t1 c.��;�u�=-es��*�l Ilu�: .���CITY: �"sa-v�i ZIP: �-�'b'c54o <br /> ST�iTE LICENSE: # 34t�A.-. <br /> ARCHIT'ECT/ENGINEER: PHOti'E: <br /> MAII.ING ADDRESS: CITY: ZIP: <br /> N�1LE: REGISTRATION� <br /> TYPE OF WORK: New :�ddition Accessory Structure <br /> Move Remodel,'Alteration� Land Alteration <br /> PROPOSED WORK(describe in detai�: �=-�,,.��s,,� � �a���.�n �.�v ��a�'<c' sc7 5�:���-�s' <br /> �"v 4 cs�- � �. F t:�_ �TJ :�— i= n�f7: LJ G /:d l.] f` l N/� <br /> � <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> l�O. OF BEDROOMS: GAR�GE STALLS: ATT. DET. <br /> EST�IATED CONSTRtiCTION VALI;:�TI0�1 (excluding land): $, q� �.:���� <br /> I hereby apply for a buildin' permit and I acknowled�e 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 Buildin� Code; that I understand this is not a permit and work is not to start without a <br /> perm.it; and that the work wiII be in a ance with the ap roved plan. <br /> APPLICAlVT'S SIGNAT . �/J� . DATE: 7'��ar _ <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> . <br /> City Counci160 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />