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� ' CITY OF ORt�I�O - BUILDING PERMIT APPLICATIO� <br /> '� � � �� � � Date Received: �� � � �:�2_- <br /> Total Fee: $ � -�/. -, ._ �' <br /> � Date Approved: <br /> Entered By: � <br /> Permit#: <br /> AT•T• INFORMATION MDST BE SIIBMITTED IN FIII�L BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ------------------------------------ ------------------------------------------ <br /> THE APPLICANT IS: (circle one) 0 ER r CONTRACTOR <br /> JOB SITE ADDRESS: ��- 3 c� i�1' �l�- O ZIP:sS3�p T <br /> (work) <br /> N� OF OwrrEx: 130�72Y � �. �1�jd,P, HS Ofj PHOri$: (home) �7/-���1� <br /> 1KAI�,ING ADDRESS: 3��-3 C// eYyY ��/� CITY: Drono M� ZIP: S J ��_ <br /> CONTRACTOR: S�� � PHONE: <br /> IKA�iLING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGIlYEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORR: New Addition Accessory Structure� Move <br /> Demo Remodel/Alteration Renovate Land lteration <br /> PROPOSED WORR (describe in detail) : ya r� v a�' r7 . �Z X �c� /, wi7`/� �r/o2r . <br /> w,%l /�uv� oh� �f''X 9� "door , Nv 6 e%w ��czc�e �oo��nsl an��o�r,����oh, <br /> STORIES:_�_ SQ. FEET OF EACH FLOOR: ! 9 � __ <br /> NO. OF BEDROOMS: "' GARAGE STALLS: ATT. "'— DET. —'" <br /> ESTIMATED CONSTROCTION VALIIATION (egcluding land) : $ ��a ��� <br /> I hereby apply for a building permit and I acknowledge that the information <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 I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accordance with the approved plan. <br /> APPI�I CANT'S S I GNATDRE: DATE:�Q tj �,�, �� 7� <br />