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, Total Fee: $ �� ��. ��`j� Aate Received: `1 U 5� <br /> ` Entered By: < _ <br /> Perx�nit#: /�c� �>'�� <br /> CITY OF O�ONO - BUIL�ING pERMIT,AppLICATIOIV' <br /> All iA#ormat�on mqst be subautted in ful� before pl�n r�view will be started. <br /> (please prin�all information) <br /> ��----••----..._.,__..«.�_�.���...w_....��__�...�_�...�r....r_�---..�..._ <br /> .�..��.. - <br /> THE APPLICA,NT IS: (circle one) OW1vER O ONTR.ACTO <br /> JOB SITE ADDRE55: � ��� ,��sS /�� - /2 � Z�P: -ss3 q � <br /> Will th�s be a Para o�Hom�es,Remodelers Showcase Home ox other Disp�ay$ome? <br /> ❑ Yes �To If yes, a special event permit is required with ,l'olice Departmenl and City <br /> Council ap,proval 60 days prior to the event. Non permftted events will not <br /> be allowed. <br /> NAN�iE OF OWN�R: � u /�iJ ��.�e�✓ PHON�: (hor�e) 2 � ��/• �t�o/ <br /> MAIL�NG ADDRESS: S/�� CITY: �work) _ <br /> ._ ZIP: <br /> SELA ROOFING&REMODELING,IlVC, <br /> CONTRACTOR: 4100 EXCELSZOR BLVD. PHONE: ��Z� YZ 3 ��'�s� G <br /> CONTACT PERSON: �� � AkK,1VAV b541 MOBILE AG�R: Z o • � �,Z. .S' <br /> MAILING AbDRESS: ��b�— Y: <br /> STATE LICENS�; # � (� �Ip' <br /> ARCHITECT/ENG�NEER: PHONE: <br /> IVIAILING Al�DRES5: CITX: ,ZIP: <br /> NA�E' REGIST�tATION# � <br /> TYP`E O�'WORK; New A,ecessory Structure <br /> Additxon � Move <br /> RemodeUAlte�ation Land Altera�aon <br /> PROPOSED WORK(describe in detai�: �� G ��ra a� �/ �s� <br /> 5TORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: G,A1tAGE STAx,LS: ATT. DET. <br /> ES'IIMATED CONSTRUCT�ON VALUA.TION(excluding land); ������_ <br /> I hereby apply�or a building permit and I ac�owledge that th�information above is complete and accutate;tlaat the <br /> wozk will be sn confoz`mance with tl�� ordina�nces ar�d Codes of the Cfty at�d with the State Building Code; that I <br /> understand this is not a�ern�it at�d work is not to statt without a permit;and that the work will be in accordance with <br /> the approved plan. <br /> APPLIC.A,NT'S 5IGNA,?URE: I DATE: <br /> � <br /> _. , ziZ'd__ 0b6'ON S3�dS �N I�OOJ d�3S Wd8E:L SOaz'6 '�fld <br />