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1 . � <br /> ` CITY OF ORC:iO - BUILDING FERl''41T APPLICATION <br /> Total Fee: $ �/ '3. �� Date Received: <br /> Date A�nro�ed : <br /> �ntered By: ,.l'�i/ PermitY- �.�(�, C� <br /> AT•T• INFORMATION MIIST BE SIIBMITTED IN FIILL BEFORE PLAN R.EVIL�1 WII.L B$ STARTED <br /> (See Check-aff List EncZosed) <br /> ---------------------------------------------- <br /> THE APPI�ICANT ISs (circle one) O��ER or CONTRACTOR <br /> JOB SITE ADDR$SS: 3�1(LU 1���� `���G1c. �� ZIP: )JJ(�%`� - <br /> � � (work) �1�� -?y�� <br /> N�ME OF OWNER-_ 1)?�'l Oh�z�l . - PHONE: (home) `� 7 y-" �`j�o� <br /> MAII�ING �D�ss: �3��� )�oc�, �1�c���. cl�: M�� zIP: � 5�.3�y <br /> CONTRACTCR: � I� - p$��� <br /> 1�iAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: '� <br /> ARCHITECT/ENGINEER: Pg��' <br /> :KAIZING ADDRESS: CITYs ZIP: <br /> NAME: REGISTRATION T <br /> TYPE OF WORR: New Addition Accessory Structure Niove <br /> Demo Remodel/Alteration�_ Renovate Land Alteration <br /> PROPOSED WORR (describe in detail) : � ��� h G�� <br /> M���� \ <br /> STORIESs ��°� SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS:� GARAGE STALI�S: ATT. DET.�_ <br /> ESTIMATED CONSTRIICTION VALIIATION (ezcluding Iand) : $ ���(�;� C�,�' <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 Buil.ding Code; that I <br /> snderstand this is not a permit and work is not to start without a permit; and <br /> �hat the work will. be in accordance with the approved plan. • <br /> I \ �`l DATE: t-I]"�c� <br /> APPZICANT'S SIGNATURE: �e 1�/W ��fi����� � <br />