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Total Fee: $ q I Date Received: '(�-0C- <br /> Entered By: oft_ voPermit#: P►- 09 1-701 <br /> CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) IOWN OR CONTRACTOR <br /> JOB SITE ADDRESS: L 5 ) ( //OP i) Oy'M(4 rA /L G( S ZIP: <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes DINo If yes, a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> NAME OF OWNER: Kp V./1 (Gt ✓h PHONE: (home) <br /> Pejo <br /> MAILING ADDRESS:066 C1'01/ + f bAi CITY:P-Pe•� o ZIP: S$31./V7 <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: <0 n yA ,i✓'l e 1f- MOBILE/PAGER: 6/ z - 7-11 <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detail): a V/1- bit in t hT0 }'�c t'DUi1.1 1 <br /> e vC t s room / i /of U�, �'�'I �� Sr sh j. 1 ti r°y ukrote vJ <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ g 0 oO, D v <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit an. work is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: I i / DATE: <br /> ')s ,a5 <br /> V <br /> 31 <br />