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' ` Tocal Fcc: $ 1,`�3�-Y-J� �ate RCceived: p��� <br /> � � <br /> Entcred By: Pemtit A�: __���____g�; <br /> C�TY UF OR�NU � BU��.D�N� PERMIT A��'L,ICAT�ON <br /> All infdrmatton must be submitted in full befare plan review will be started. <br /> {please prinr a�l dr�f'dr�uxtran) <br /> --.--------_____.._____�_____..__..__..�_..._�._____T ___.,T_____�____..------------- ____.._ _____.._..__.._..___.�..____.._M�_ <br /> T� APPLXCANT IS: (circle on�} OWNER. OR NTRAC'�OI��`� <br /> JOB 5I'I'F �iDI)ItESS: ���� �A-����s's- a��� ZIP: <br /> c'j���:� <br /> • � � l_�'/�d a�.t r? � <br /> NAME OF UWNER.���' � _ _. __ _� g /7�-"/`�- P�OI'V�: {home} <br /> t..s �,: �:s�rb.., ' (worl�_ _......._._ <br /> 1�1lf�li,V t7�Al��a7�:��� / �.I e.�'t ier�c ��rl i: �T l:�,-J v L��: <br /> CON`CRACT4R: S��� C�.,r�ru�.75�h�, Lr-� P�ONE:l��� �'' - ��-,/-�/..�� <br /> CONTACT P�RSUN: �'� �-� .rr MOHIL�/PAGER:���?'d'' • �-q/3y <br /> �AI��G AUDRE.SS: ����� � ��� CITY:_�S.4r �i" _ZIP: /fY�.f -. <br /> � <br /> ST'ATE LI�ENSE: �.�v z / �, S�- sT- <br /> A,RCHITECT/ENCirIN�:ER. PHONE: <br /> MAILINC ADDRES�s CITY: ZIP: <br /> NAME: �W�..._� RECIS'I"I�A'�ION# <br /> TYP� OF WO�tK: New ddicion Accessnry Struccure <br /> _ _ __ ---- <br /> IV�ove _ Remad'e1�{�1lt�xation � x Land Alteration� <br /> FROPO5EU W4RK(describe in detai�: ���.�� ��_L, ,;.�, ,/�c-�„,��� � y _ <br /> _.�,.�'r! L-L;'9'z�Z � .,q„-,,�..,C��1�,�,1,s SL T E' �I-�9r�. !� '��,,,_,�,'`�-i' <br /> / <br /> STOR�S: � SQ. k�E'I'OF E�C�FLOUI�t: <br /> � _ _ . _ _ <br /> N4. O�' $En1ZOOMS: GARACE �TALL5: ATT. DET, <br /> ESTIMATED CONSTRUCTION VALUA'I'I()N (ex�luding I�d}; $��� 6ZS'� _ � <br /> I hereby apply for a buiiding permiC and I ackna�+ledg� fhat the infarmati�n above is caz�pletc �nd <br /> accurate; that che work wi�M he in conformance with the ordinances anQ codes� o�t�ae City a�ad�uuith <br /> the Statc Builcling Cade; that T under��rul this is not a pecmit and work �s nnt to st�rt wlthaut a <br /> permit; and that the work will be in accordancc with the approvcd plon. <br /> /' ,�--- <br /> A.PpLtCANT'S S�G1�1A'I'U . > "Q�_`°" DATE: S � /�1.� c� <br /> NpTE! Para�� ��',�j'Qttt�,� events requlre separu e pe t ap�proval by Pol��e Departman� a�d <br /> Clty Council 60 days pr�or to the event. Non perntitted events will not be all+awed. <br /> 5 <br /> 059�ON 8Q/I,0� � LS��L 00/80/SO 91,9h6hZZ L9 � ON0210 �0 A11� <br />