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A.ua-13-2002 '�0:31am Frcm-CITY OF ORONG +9522484616 T-820 P.00'JG02 F-d48 <br /> Total Fee: ��` ��• �3 Date Received: �J'���-_-_� <br /> En�ered By: l � Permit#; �D 5' 7� <br /> �,,i� �� CITY OF 4R0. '4 � �L'TL�1NG PERMIT APPLICATTOIi�T <br /> �� Al1 inf�rmation must be submitted i» full befare plan revievv�wiil be started. <br /> (please print all inforntation) <br /> ------......--------------------- <br /> THE; APPLICAI'�I`I' IS: (crrcle one) OWNER OR CONT].2ACTO�t <br /> .�OB SITE ADDI�SS: ,��i�5�� ��`��-S�G/'c% ,��" �YP: 5�- � <br /> NAME OF OWNER: �/lL.�`e"r- PT�C}NE: (home) <br /> � (�vork) <br /> 1VL4II.L�TG ADDRESS. r?��/�5/�/�rf/� .s%I�rG/-�i'CYTY: O!'Oh1 .��,_ ►�_ZII": •—s,3 9" <br /> corr�ac���t: � +e� P"oo��yl�/ss�,� ..Ze«PH�NE: �.5��-_��/�-1d0�'�` <br /> COI�TACT PER50�: — � i'a� M�B1L�+/PAGER: — <br /> M.diYI.�NG AA1�IR�SS:/G�yD u��./�_nt r- �i/a 5�f;I`I`�': /'�dr /.e�- e ZTP:�SS�7Z <br /> STATE LIC�:'�SE: #�--� _ _ n <br /> .�RCT�'!'T�CT/ENGYNEER: P1I�1�'E: — <br /> MAII.�1G ADDkESS; _ CiTY: Z�': � <br /> NA1��E: �_ REGI�STI2ATIQN!/ ,� <br /> T'YPE OF WC1RK: Nerrr � Addition Accessory Stnietu�•e <br /> Move RemodellAlteration Land Alteration�__ <br /> !y'�2QPOSED'�'VORK (describe in detczi�: �`�' 3�� :�t�i�? _��t� � ��' <br /> �� �/ <br /> STORYES: SQ. FEET OF�ACH�'Y.O�OR: <br /> ;1'p. OF BE�R.00MS: GA.RAGE S'CALLS: A'TT --- DET.� <br /> EST��ITED COaYSTRUCTION '�ALU.P�TTOV (exclud�ng land): ���pOC' � ��� <br /> I hereby apply for a building permic and I acknowledge th.�t the informatian above is complet� and <br /> accurate; tha[�'work wi11 be in conformanc� with ihe ordina�rtces and codes of Che City an�i�c'ith <br /> the 5tat.� Building Code; that I understand this is not a p�rnlit and work is not to starC 'without a <br /> permit; and chac che work will be in ac�ordance with th� approved plar.. <br /> . <br /> :a►FPLYCA,�VT'S SIGNATURE: �-.�-�,--..��-�—�f,-� DA'T�: '�2��Z <br /> L= , <br /> NDTE! ,�ar�d�, o,�Hom��; events require separate permit approval by Police 1�epartment and <br /> City Counesd b0 c�ays prior to the e�vent. Non permitted evenfx wiil not be allow�d. <br />