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CITY OF OROI�,� �,,�RIIILDING PERMIT APPZICATION <br /> Total Fee: $ Date Received: <br /> Date Approved : <br /> Entered By: " C" ) <br /> Permittt: �, .7�_� <br /> ALL INFORMATION MIIST BE SIIBMITTED IN FIII�L BEFORE PLAN R.E�7IET�7 WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> ------------------------------------------ <br /> TgE APPLICANT IS: ( circle one) OPINER or CONTRACTOR <br /> JOB SITE ADDR$SS: i'��L�S� ���1'1 � �- � r"`�-� /��`''!-_ ZIP: <br /> (work) _. <br /> . ��- �;` ���`,�1 �t_ !- �`- �� %� PHONE: (home) <br /> NAME OF OWNER. ' � <br /> MAILING ADDRESS: CITY: ZIP: <br /> ��7z- �l� z� <br /> �,�.�\--�,`�---�, --L�- �j ��r.�� r��� PHor�: � - '�- <br /> CONTRACTOR: <br /> „ . „ :, � . _,�_ Z-�( (�/ <br /> MAII,ING ADDRESS- � . �.. Z`�� fivF�� CITY:"�`�"'' ZIP: _ <br /> � l�S v� �U(,)r�/,� �' <br /> STATE LICENSE: � (�,c.� ��7�� <br /> ARCHITECT/ENGINEER: PH��� <br /> MAILING ADDRESS: CITY: ZIP: <br /> N�: REGISTRATION n <br /> TYPE OF WORR: New Addition Accessory Structure riove <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> /C ,� rL ;', � 't �.., C} ���,-�. �._�l�l�C��`i:�...��'�-�,f�t� <br /> PROPOSED WORR (describe in detail) : ( <br /> � _ .�. <br /> ��J= 'L C�C� <br /> STORIES: � , L-- SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ���.-C.- ._ -- <br /> ESTIMATED CONSTRIICTION,VALIIATION (ezcluding land) : $ � <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that _T <br /> understand this is not a permit and work is not to start without a permit; ana <br /> that the work will be in accordance with the approved plan. <br /> � <br /> r � `-� --- `� � <br /> APPLICA.NT'S SIGNATURE: <br /> ������ �.�,%c��..,C�'�J�.. DATE: .5 �S^ - <br />