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CITY OF ORU2vv -� BIIILDING PERMIT APPLICATION <br /> Total Fee: $ <br /> � �. �s/ Date Received: � � � - �S .. <br /> /� Date Approved: <br /> Entered B ' <br /> y' Permittt: .�' y/�- <br /> AT•7• INgpRMATION MDST BS SIIBMITTED IN FIILL BEFORE PI�AN RE�7IEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ------------------------ <br /> -------------------------- <br /> TgE APPLICANT IS: (circle cne) OWN or CONTRACTOR <br /> /J��i�,u.-'� /i � ZIP: ��� � / <br /> JOB SITE ADDRSSS: , ; r�� v ` � <br /> (work) <br /> � -- <br /> i' ° <br /> NAME OF OWNER: _ �'=�! '�- l!'L!'.�'1/�'` � C � ���'����� PHONE: (h ome)��� �- <br /> MAILING ADDRESS: ����S ✓��� �! ��%' � CITY: �,�����'�"�/� ZIP: S-����� <br /> PHONE: <br /> CONTRACTOR: <br /> ------. CITY: --------- Z IP: ___ _ <br /> MAII�ING ADDR.ESS: � <br /> .--------_ <br /> STATE LICENSE: # <br /> -----_ <br /> __ _ PHONE: <br /> ARCHITECT/ENGINEER: ----- - - - <br /> CITY: -----_ <br /> ZIP:� _. _ _ _ <br /> MAILING ADDRESS: ___—__ <br /> _- ---- <br /> NAME: __ _ __ _ REGISTRATION n —. <br /> TYPE OF WORR: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration_� Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : �l� G��! �1���✓ <br /> STORIES: �_. SQ. FEET OF EACH FLOOR= �� � <br /> NO. OF BEDROOMS:� GARAGE ST�LS: ATT. DET.�� <br /> � /�'� CE <br /> ESTIMATED CONSTRIICTION VALIIATION (egcluding land) : $____yL�S�`---J ._.._ <br /> � <br /> I hereby apply for a building permit and I acknowledge that the informatior: <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 "� <br /> understand this is not a permit and work is not to start without a permit; ari <br /> that the work will be in accordance with the approved plan. <br /> � ' y � <br /> f�,�� �Z,,u,�.�-- DATE: ��y /< <br /> APPLICANT' S SIGNATIIRE: � � ' C�'� <br />