Laserfiche WebLink
CZTY OF OROAO - BIIII�DIA'fG PERMIT APPI.IC�TION <br /> Total Fes: $ ��. �� Date Receined: <br /> �� �� Date Approved: <br /> Entered By: -� ��� <br /> Pe_rmit�: <br /> �L I3JFORMATION �IIST B8 SIIHMITTED IlY FOZZ Bffi�ORE PLAR 1tEVIEW WILL BE STARTED <br /> ------------------------------------------------------------------------------ <br /> T� Ap�LIC�IAT IS: (circle one) OWNER or ONTRACTO <br /> �JOH SITB ADDRESS: `�'`� �� +v��l f 5��� � • ZIP: <br /> (work) <br /> NAME OF 03�iN$R: �(�.��`��c\�, ���.���►S o� PHONE: (home) <br /> MnTZING ADDRSSS: u�{ S�'s� fnb;2TN�v rt�' �.�°Z CITY: Q2�o 1'V c� ZIP: <br /> CONTRACTOR: �N�i�• �V'`� ���} �e��-�`N+� pHorrE:�1 a-b�"3�l- <br /> . _ ,,__,- <br /> MAILING ADDRES S:�� 7� Li N��'.� ���� CITY: . u�,iv{� ZIP: ����•��� " <br /> TYPE OF WORR: New Addition Acc�ss�X� Structure Move <br /> Demo Remodel/Alteration Reaovat Land Alteration <br /> PROPOSED WORR (describe in detail) :���� -������m�� <br /> ��� CSF� �F�15�(N� Z. C,P'`(��.� dr- �.�;S� � t�/� � � <br /> STORIESs � SQ. FEET OF EACS FLOOR: <br /> N0. OF B�ROOMS: GARAG$ STAIZS: ATT. DET. <br /> ESTIMATEn coasTxuc'rlo8 4Azu1�lTIOR (eaclnainq laaa) i $ �3�� o °•� <br /> I hereby apply for a building permit and I acknowledge that the informatic <br /> above is complete aad accurate; that the work will be in conformance with tt <br /> ordinances and codes of the City and wi�h the State Buildiag Code; that <br /> understand this is not a Fermit and work is not to start without a permit; ar_ <br /> that the wosk will be in accordance with the approved plan. <br /> ; �\ n \ - -� <br /> �iPPLICANT's sIGPIATORU: vv DATE: � � U � <br /> (Please fill out the reverse side of this form) <br /> 4 <br />