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11/13/2001 21: 23 9524726539 WF SMITH CONST: PAGE 01 <br /> Nvv11-2001 OA:16om Frcm-CITY OF 4RONG � +o6Zz494b�� �—ivi r.������� � •-- <br /> o�al Fee: $ / `C/�� � ,~� Dace Recxived:_� ��� -�' <br /> T - porn�t�; <br /> Enceced B -�-% <br /> �' ; ..,;;l�' /' ,'j�c�; <br /> C�TY OF ORO�VO�•�B�7ILDJIVG PERM�T APPLICATION <br /> AU intorm�tior�must be submitted ia full btfore plan review vv�U be started. <br /> �__ -----------... --__�..�teasc print al! in�ornwrioR)----------------_..._�---..._._-- <br /> T�,�ppj,YC�yT ig:Y (circle one) OW I�ER OR CONTRACTOR <br /> JOB SITE ADDRESS: CRSCG �� � �IP: Ss39 � _ <br /> I i�l ICC u►� PY3o1�T; (home) <br /> NAME OF OWNER:�� ----� �wark) <br /> MAII.IlVG ADDRES5: 7 G I 6 C�sc o CITY: <br /> z�:� <br /> ONTR�ICTUR: V V F SI1^��I�' �/`�s�' PHOlY�: �?��– _ '�s3 /� <br /> � 1�OH1LEJpAGEx: �3 �r <br /> CONTACTPERSON: � . ZIP: �3�� <br /> !VIAYLING ADDRES9: 5C1'7��YI`�woo��.�l62 CITY: Gv �.— � <br /> 3TATT L.IC�NSE: M o <br /> ARCHITECT/ENGTNEER:^ PHON'�: <br /> MAILYNG ADDRESS: ,_ _ CITY: �� �— <br /> NAME: ,_ REGYSTRATION A� <br /> TYPE dF WORK: New Addition -- ��0ry�� <br /> Move RemodcUAlu:racion�, Land Alceracion <br /> PRC)P03ED�+VORK(c�escribe in d�tail�: __�.__� � � �'�'`5 � � <br /> STOR�ES: SQ.FEET OF E.�1CI3 F'L�OR:_ <br /> NO. OF HEDROOMS: -- C7AltAGIy STAY•Y.S: ATT. DET. <br /> � 6 � �'c� <br /> TSTIMATED CONSTRUCTION VAY.UATION (excludi�land): $. � <br /> I hereby app1Y for a building permit and 1 acknc,wlcdge that tb�e iaform�tion�bove is compl�� <br /> accurata;tha�the work will be in conforcn��ue with�he oidin�t��es and codes oP[hc City and with <br /> thc S[ata Building Code; thai I understand th�s is no[ a permit and work is noi to stari without a <br /> ��u�� a�d that the work will in accvrda e wi tlu� appmvcd p1an. <br /> APPLYCANT'5 SIGNATUR.E: ,�. <br /> DATE' ` I ' �� � p � <br /> NOTE! ��e Q1'K��eVe�� require se�►urate perntit app�oVul by Pol�ce Deepd�e�t a7ul <br /> Ciry Council a0 days priv�to the event. Non perniiKed even�s will rwt be allowed. <br />