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Total Fee: $� (,.:-C �i�� Dato Rcceived• �J����'-� . <br /> �ntered By: � �7�� Permit#: � i.( �'�t�� � . � . <br /> �� . : <br /> � CTg'Y OF.OROI�TO - BUII.DII�(C PERMIT, �P�'LICATION � . ' <br /> information'ff►ust be submitted in full bePore plan revi�.yw will be started. . � � � <br /> _ ;� (please print all i�'iornuuion) _ � ' , <br /> LGt. ��� <br /> �tgE A,ppLICANT �S: � (ctrcle one)� O'WNER OR. ONTRACTOR � <br /> _ .._........ � �� <br /> Jo8 s��DxEss: I�1 r�� '-D2. �� ' ' z�: ��3 9/ �� . � . <br /> L(>>4�zi4Ti"� ► /��7, . . � . � <br /> N�ME OF OWN�R: - � � �aCRvr� .P1�ONE: ���,���67 . <br /> . (wor�) 5'S _ ys`� . <br /> �u,nv�Ann�ss: /9sl e crn e��/�►� s-�� crr�: w��z�f� � z�P:�� � <br /> . -Q . <br /> . CON'TRACTOR �d�� �� �a� :/c�Z � ' PFiQNE: �!o�/ - - �o, . <br /> CONTA.CT PERSON: �� �e . MOBILE/PAGT.R• / 8�-�- � <br /> � MAILIlVG ADDREaS: 7�f��vilo � ' � CI'T'Y:L:.� L Z�: O/ . <br /> STATE LIG�NSE: #�1 7�l�,� <br /> ARCHrI'ECT/ENGINEER:_ PHONT: <br /> MAn.IlVG ADDRFSS: � CTTY: Z�•� _ � <br /> NAMT: _ ---- ._... RTGIST'RA.TION f� I . <br /> TYPE OF WORY�: Ncw Additioa Accc•ssary Sauctu��� _ . <br /> � Mov� R�model/A1tc:ration�„� Land Alteration_ I <br /> ORK describe Fn detain: � ' ' ���� <br /> �'ROPOSED W ( <br /> .w_, • . <br /> STORIES: SQ.T�ET OF EA CH FL04R: � . <br /> NO. 4F BEDROOMS:� GARAG��STALLS: ATT. DE'T. <br /> 0 <br /> - ��rEn coNs�vrrzoN v�,Ua,�xorr c��uai��a��a�; � ._ <br /> � <br /> I bereby apply foc a building permit aad X a�la�ov�+ledge c�az tt� '�or�atioa above is cq� ete aad <br /> acCULase; tha�the work will Tx in confo�rmance with tf�ordinaaiccs aAd codes af the City with <br /> ihc State Bu�diug Codc; that I und�rst'a�nd �his is noc a permiL and wo�k is not to start w thout a � <br /> petmit; and that the wotk will be in Accardance�►irh the approved plan. , . • <br /> APPLIC�1►N'r'S SYGNATI7R�: � ��� DATE: �' � 7� . <br /> . I <br /> NO2E! everrts require sepdr�ate permil approval by PQlice Depa , rtt r:nd � <br /> City Cortnci160 d�ys prinr to the erent. Non perneitted events wJl aot b� allowed. �. <br /> 100/100 'd 58���DOW�B WO�S�� 6I � O i (���) �002-12-��d <br />