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F�'Of1 . Tirn}_��r-1,i.r�rl. E��_1i 1r�.�rs F'HCihJE ha0. . 5i� '=+4'� �_�_��� _T.�r�. �Zt.^ ��=i�u=i 11: _^Hf�l F'� <br /> Tot.ai Fee: o Date �Zeceived; „_,_ <br /> Entered By: _ Ferzz�[t r�: �� ;;�[�c; _ <br /> C�TY �F OR.ONO - SL�LDINCx PERIVX�T AP�'�ICATYO�T <br /> A!t i�if�x•�iiatia�x mnst be s���mittcd in �ull before plaz� review «�11 he started. <br /> (pl.ease�rint all infonnativn} <br /> 'i'HE A,�PLI�A�.NT IS: (crrcle orze) 4W R O CUS�'TR.AC"� <br /> . <br /> JQB SITE .ADDRESS: zT�: —=� <br /> �YAN� ()F �WNER: { `� PI��N.E; (home} r �' <br /> { ork) r � , <br /> :V��ILIlVG A�DDRESS: , CITY: ZIP: , <br /> 1 <br /> COi�'�'R.ACT(��2: ` i 5 PHOIV�E:_ a � ��,� <br /> CON'I'�1,CT PERS0�1: �T4STx.,E�PAG <br /> 1LAILINCx A�DRESS: T CIT�.': � � ZIP: <br /> STATE LIC�NSE: # � <br /> ARC�iT�`ECT/ENGIN�ER: F�Q1VE: <br /> ti1A�LING ADl)RESS: CITY. ZT�': <br /> �e�,�,�; �2EGIST�.ATION# <br /> T�'PE OF WOR�; N�w A,dditian Accessoay �trueture <br /> Move �Remode]./Alteration a d Alteration <br /> � <br /> � 4P4SED��OR� (�lescrlbe i��clezur.'l}: �t — <br /> -� <br /> ST�RY.ES: SQ. FE�T OF EA�H FL04R: <br /> NO. �� BEDROO�VIS. G��t.AGE STALLS: ATT'. 1�E�. <br /> EST'Il`IA'�'E�7 CONS'�'I2UCTIC}N'VALUAT��N ex�l ' Iand}: $ '� �' <br /> 4 � ��} � <br /> �r )i�� '��I_ �������h�W�� ��� <br /> I hereby apgly tor a bu�lding permit and I ac�Cnow edae that t� �i fo�fiion a ave �s cor$ple and� <br /> accur�;te; i.ktat the wnrk��?111 b� in �anf�??•mance; wit�i th� or�inanc43 and codes of the City and with <br /> the State Buildin� C���e; that I u�iderstand this is not a p�r 't and �voz�k is not to start without a <br /> permit; and thac tlae ��c.�rk w�Xl be in accord• nce �,vith th a 'ed� lan- <br /> � C�' � ,I)A'I`E: 1 � <br /> A.Y'PLICANT S SIG:^vAT�TRE: <br /> ,� � <br /> 11�'OTE! �f �e events require separate perrrcit proval by Police 1�epartntent and <br /> Crty Cotcrtcil �S4 dcrys prior ta the event, l�'a�i perrrtitted etifents ti�>zll not be ail�wed. <br /> 5 <br />