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Jun 06 02 11 : 24a p, i <br /> CI Y OF�.ORON � 6122494616 OS/31/99 10:23 � :01/03 N0:429 <br /> �er���3 S .�0�� SC33 � <br /> Total P�e: � Date Received: (:� �, �� z-- <br /> �j �,Eutued Sy: Pern�it#: ^/7� /n <br /> a`��/ CIT� �F ORt�N� � BXT�'L�ING �'EI�MiT APPL�CATION' <br /> .�� � . . <br /> (� �' N� � A!l 3�f'cnmat3cyn�must be�ubmttted in f'�D before plan review will be �arted. <br /> v (p�ease prtrrt�lt�l�f'orma�ion) <br /> � T'IiE APPI�.iCANr iS; (ci�cle oice) OWNER CC3NTRACTAR y <br /> .JOB s� �n��ss: a?oo ���( �1�e., ...._._,zrp: .�5 3 � <br /> � . �q��) <br /> � NA�M[� oF t�vvx�R: i_.:�,�-�- .�e n S���� PHONE: �n��� ��l- �r r5 <br /> NYAIL�G A.pDRE.SS S�r�.dv��S-�' ����. �/ Ci'I'Ys �wQrk) ZIP: <br /> . � <br /> WINDOUII LITE Home Im rovements c��� ���/�� (� <br /> ct�rrr�a�c��: p �xort�• ���3� �/-�3 i � <br /> GQNT�CT P�RS � �ILE/PAGER: <br /> � MAIY.INC ADD � � CX'1'i': � 7.IP:� <br /> S'�'ElTE LICENS +Y ' 3 �/�0 <br /> ��`3�� - ��� ' � 3 <br /> ARCY�1?�'�CT/ENGII�TEERt ' �� _ PHONE: "� <br /> NYAII.II�TG ADDRTSS: C�TY: ZIP: <br /> 1�A1ViI�: REGISTRATIQN� <br /> TYP� OF WORK: 1Vew� Additioa Accessory �truGA�re <br /> -- <br /> � Move R�modcUAlteratiaa LAJJICj A1tC�8tlOA <br /> �.tOPO��D WORK(rlexcribe arr�letc�in: �o.������- r�,���� --�c'� �� �a� <br /> �.�� Q�.��.�� <br /> 5T(?RT�S: SQ.FF.�T O�'�!I►CI�FI.00R: <br /> NO. O�'�EDRO��KS: GAYLA4E�TALI.S: ATT. � DET.� <br /> �/ ��i <br /> FS'i'Ih�IAATED CONST�tIC'Y'IO1V'VALUATIQN (excluding l�nd): $ �(�`-/��'. ,,.,� <br /> i t�ereby�ppiy for$buiiding pe�nit and I �clrnowtcdge that the�nformatian gi�ove �s complcte and <br /> accurat�; that tY�wark will be in co�for�nance w}th the ordinances and codes of tho City a�nd wfth <br /> the State Building Cade; th�t I underatand thIa is nat a permit aztd w�rk is not to stact without a <br /> permit; and thet thc work will be accordance with �he approved plan. <br /> � �` � / <br /> AI�PLICANT'S 5IGNAT �` Y' �E- . z ' � ✓'�- 1"jATEs �p- C���� , <br /> '��P3 3`�1-�31� <br /> 11�'OT��;j l�a�ade oFHnmes e�enta requfre appanrt�prrralt approvaC by pottce t.�epartment and <br /> CY�y C'ouncl160 days pr�or to ahe event. Non perr�ined events w�ll not he allowed. <br /> . 5 <br />