Laserfiche WebLink
� � CITY OF ORC:70 - BUILDING FERtiiIT APPLICt�TION <br /> � <br /> Total Fee: $ Date Received: <br /> Date A�oroved: <br /> Entered By: Pe�-mit ;�• <br /> AT•T• INFORMATION MIIST BE SUBMITTED IN FIILL BEFORE PI�AN REVIEW WII�I, BE STARTED <br /> (See Check-aff List Enclosed) <br /> -------------------------------------------- <br /> THE APPLICANT IS: (circle one) O��TiJER or CONTRACTOR <br /> JOB SITE ADDR.$SS s ,�J< < ��'c� �'� � 1S ZIP: <br /> � (work) <br /> NAME OF OWNER: (`� V G C PHONE: (home) <br /> .�- <br /> MAII�ING ADDRESS:��� �,�[7 .�% �h�` � . CITY: ZIP: <br /> � ti � N �� PHorrE: � `� ��"� �=`'`% �� <br /> CONTRACTOR., /�/�� � <br /> :�iAII�ING ADDR.ESS: ����C�%(� � 'y.� ���Dt.r� CITY: -�.� ZIP: �' � <br /> STATE LICENSE: _ <br /> ARCHITECT/ENGINEER: PHONE: <br /> ��+iAII.ING ADDRESS s CITY: ZIP- <br /> NAME: REGISTRATION � <br /> I�YPE OF WORR: New Addition Accessory Structure biove <br /> Demo _ A�i.-on Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) - � � � �`-' �� �"' <br /> �.�P� C'�,/� .�C ��`J � � U �'�� /fJ :i ����-�P <br /> �� <br /> STORIES: �....- SQ. FEST OF EACH FLOOR: <br /> �7p. pg BEDROOMS-� C�AGE STALLS: ATT.� DET. <br /> ESTIMATED CONSTRIICTION VALIIATION (excluding Iand) : $ � � f/��'�- <br /> I hereby appiy for a buiiding permit and I acknowledge that the information <br /> ibove is complete and accurate; that the work will be in conformance with the <br /> �rdinances and codes of the City and with the State Buiiding Code; that I <br /> .znderstand this is not a per:nit and work is not to start without a permit; and <br /> �hat the work wi11 be in accordance with the approved plan. • <br /> i�PPLICANT'S SIGNA -�� .� : DATE: <br /> � <br /> a�. � <br /> L � y . . . . <br />