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CiTY OF ORCNO - BIIII�DIiYG P�R3�SI'I' r�PPIiIG�TION <br /> �ai �r ee : $ �j v� 07 � S�� Date Received: �- / � - �� <br /> Date Approved: /� - i 7- �/ <br /> �ntered By: L/��� � <br /> Permit�: <br /> ?�T.T• INFORMATION MIIST BE SIIBMITTED IN FIILZ BEFORE PZ�AN REVI�+T WILL Bg STARTED <br /> (See Check-aff List Enclosed) <br /> -------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one ) OWNER or CONTRACTOR - n , <br /> �-/�S f�lu.j 2�c_z_w' ,/�, <br /> � �/ <br /> JOB SITE ADDRBSS: ��yUl�lw °� .���I �[�� ZIP: <br /> (work) <br /> NAHE OF OWNER- l:L�}�i2 /�o G� PHONE- (home ) `/T/-�sfi� <br /> MAILING ADDRESS: �'�'�s ���/Gio�� cc%.y _ CITY: T,c%-y 2,¢�.�I ZIP: SS3 py <br /> CONTRACTOR: ��/�C /'�� � PHONE: �''�/'�a���� <br /> MAILING ADDRESS : .3 u....t CITY: ZIP: <br /> TYPE OF WORR: New � Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : /�'L°w ��s'e <br /> STORIES s -� SQ. FEET OF EACH F�OR: '8�` <br /> �IC�z QF 3�ROOM�� 3 G.ARAGE STALLS: ATT. �L DET. ' <br /> �STIMATED CONSTROCTION VALIIATION (egcluding land) : $ lo � �''o 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 /> � �.�` �--- <br /> APPLICANT'S SIGNATQRE. . / DATE: 9��0' — r/ <br />