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. <, � , :� -r/.�y <br /> . CITY �F ORQNO - BIIILDING PrRMIT APPLICA'rION <br /> Total :ee• S � `? � � - � � Date Received: <br /> Date A�proved: <br /> � _ _ <br /> �atered By: . �1� � <br /> Per�it Q: 'f-= �% <br /> ALT, INFORMATION MIIST Bg SUBMIZTED IN FDLZ� BEFOR.E PLAN REVIEW WII.L BB STARTF� <br /> (See Check-off List Encl.osed} � <br /> --------------------------------------- <br /> � APPLICANT IS: (circl.e ene) OWNER or CONTRACTOR <br /> _ �- -� ,�-.- <br /> , ;- , ��;>' �r�_ ZIPs '� <br /> JOB SITE ADDR$SS: -� '�? , ,=�" <br /> (work) <br /> 1 � ' <br /> ;�''t.� ,�;�� �, ..�- � � PHONE: (home) �f) � -�� Z� <br /> N�ME OF OWNER: 6 r ; f; �/ '� ` <br /> 2�.A.ILSNG ADDRESS: CITY: ZIP: <br /> CONTRI�CTOR. j �. , � ,° �,: �r��� (_� � ;.> :�����0�� PHONE s � ��% � � ��-J� <br /> ; ,, ,� � � ' ,% ;���.'i_'c c�;�%�l ZIP: '"� Ci��/ f <br /> N.AILING ?�DDRESS: � : : ;�� �7� i � � ����.'i t yt'd, , CSTY: - <br /> STATS LICENSE: ,� <br /> � y �r .,.� ,, , <br /> { ,T ,' _ �,:, , <br /> "' <br /> �'�RCHITECT�ENGINE�t: ,'� - % =� � ���I" :�� •� , PHONE: � _ � _ ' �' <br /> MAII�ING ADDRBSS: CI�Y: : ZIP: <br /> N�: RSGISTRATION a <br /> TYPE OF WaRK: New�� Addition Accessory St�ucture Move <br /> Deino Remodel/Alteration Renovate Land Alteration <br /> ?P.�PGSED WORK (describe in detai.l) : �� �G Y' ��� -f f?�' <br /> , <br /> STORIES: `L SQ. FEBT OF EACH FLOOR: _'" ' ' '?°' . <br /> 2x0. OF BSDROOMS: =�- GARAGB STALLS: ATT. DET. <br /> �STIHA�ED CONSTRIICTION DALIIATION (eacluding Zand) : $ ` � - <br /> � <br /> ' hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the wor�c will be in conformance with the <br /> or3inances and codes of the Ci.ty and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> ��at the work wil.l be in accordance with the approved plan. • <br /> � f <br />` �"'�� �� � � DATE: � �--ti <br /> ,r�pPLICANT'S SIGNATIIRE: � � ' � ; � '"-���� � <br />