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� 1C.�19%99 TL?E 11:16 FAY �pp� <br /> FROM :SCHDELL 8.: h�1RD:4N 612 54F 9065 1999�Zc3-1'� 4�5:p3 #7a7 P.�'�;'D2 <br /> �� <br /> Taia.l Fee: $ � `��� <br /> Date Recei��ed: <br /> Entered By: —�?�„ Perm.it#: �� <br /> �_�� <br /> CTTY ��' ORONQ - $UILDING PE��"1' A.P'pLICA'i'I�N <br /> All information mus# be submitted in full before plan review will be started. <br /> (please print dll r.'nform�rron) <br /> -------------------_�.�__..-------------_._--- <br /> ---- -------� <br /> - .------------- <br /> T�-TE APPLICANT IS- {circle one} �WNER OR CpNTRA,CT�R ,- <br /> JOB S�'I'E ADDRESS: � D �t� f`/'e�7�'"_ ZIP: <br /> NAh� pF Q`�'�;R; �,�c an r'/aGIrI%�!�� _ 1'I�ON�: (home} <br /> (woric} � o <br /> MAII.ING A1�D�tESS:/�/ ,1r1���t�or�� �.a��o C1TY: s�t ZIP:ss��� <br /> C�NTRA,Cx'OR: � �u ! FI'lONE: (��o�- �T�-����- <br /> CONTACT PERS�N:_ �,�� ��'�r' s_ ,' �- MOBILE�PAGER: �,/a--- � .. <br /> 1VIAZL ,.Tiv.G.ADDRESS: , � <br /> STATE Z.rCENSE: #_�2(0�,� r� S� CITY: ST i�o,,,, l�c�� ZIP: 5�'�.1/G� 3S6 <br /> A�.2CHIT�CT/ENGINEER:�qp �ra�! /1G PHpNE: —���-7641 <br /> MAILIl�G ADDRE3S: CTTY: a� ZIP: i��� <br /> N.A.�LE: ,--.�.l� REGISTRA.TION�1� d <br /> TYPE OF yVQRK; New Additian Accessory Stnie.�ure <br /> Mo�e Remodell�lteration Land Alteratioa^�_ <br /> P`R�PaS�D WORK(describ�in detat�: � ' � � 8 <br /> � <br /> STORIES: SQ. FEET QF F.ACH�I.�OR: <br /> NO. OF BE�?�OOMS: GARr�.GE STALLS: ATT. D�T. <br /> �STIMATED Cp1�STRUCTION VALUATIpN (exclucli:ng land): $ ``� , C� <br /> I hereby applv for a building pernait anci I acknowledge r.hat the �ot��rion abvve is-complete and <br /> accurate; that the work will b�� i7rx con�oznn�nce with the ordiaaa,nces and cades of the CityT and wirh <br /> the State Bui,�diztg Code; that T undezstand thi ' nat a permit and work is nvt ta start wi[h,out a <br /> petmit; and that the wc►rk will be in aC r -anc ith the approveS p1an. <br /> 4PPL�CAi�1T'S SIGNATURE: � . DATE: D <br /> NOTE! p�_u,de of HQ„me.€ events r�eqtiire separate perrnit ccppravul by PoTice Depa�thxent and <br /> City Caur�ciX 60 days pr�zor to the eyent. �Vox:permitted events will not be allowed, <br /> . 9 <br />