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08/0112602 16: 40 9529309921 SAM AT SELA PAGE 05 <br /> Au�-01-2002 02:28pm From-C11Y OF ORONC +B6�2d64616 1-t42 P.DOS/906 F�'t�4 <br /> ,� �— �� ��� <br /> Total Fee: $_ �'�``��°� -' �' Dart Receivod: r <br /> �n�ered By: ' Permit#: ��� <br /> � �� `,�-'/ <br /> , - CTTY bF OltOl�rO - BULtiDYNG PERMIT APP�.�CATION <br /> r� '�U <br /> GV� 'All inPorttsaiion must be submitted in full before plan review �vill be started. <br /> �� r�'�'�� ` (please prrin�ad! informat�on) <br /> -------- ----------- -.-----------_-�---� - - ------��- ----�--�.�.,._.____,..----- <br /> THE APPLICANT YS (circle one) OWNER OR CONTRACTO� <br /> .TOB SITE ADDxE5S: /'�OS dr� t'� ZIP: 5�'3(0 <br /> NANII�OF UWNER: _�SJ�,'�f�t ��d�"�r PHONE: (home) 9az•4'72.1679 <br /> (work) 91fZ.b3G,a�c7/ - <br /> , ;VIAIIr�4�iCrA�D�SS: /fd5 p�r� 4� CITY; rr��o ZIP: s.ss6 <br /> ,, _ <br /> L I�; R�CTOR: 5 C(a. P•oofiin R+�w�a PHOIVE:, 6��•g�3.�k�6o <br /> ;' � CONT <br /> �� � ^ aN'�ACT PEI2SON: ��- N�o�_...MOB ElPAG�R: �z� 4�. $�o <br /> �� �'t (�i�,�� 1NG ADDRES5: �_�Iv�_CITY: 56 ZII':�f� <br /> r�' ��s�� �,YCErts$, � <br /> �.__._.�= <br /> ARCHITECT/ENGINELR; P�ONE: <br /> MA�1T,Il`'G ADDRESS: �_ ---C�' ZIF: <br /> ��E: �_____REGISTRATYON!� <br /> TYl'E OF WORK: New Addidon � Accessory Strucmre� <br /> Move Remodel/Aleerarioa Land Alteration <br /> P��DP SED�vOYtY� describe itt et�in: �St?-�1 ���� �"�4�' _ <br /> �1'�� -�"D e.o � rt� <br /> STORTES: _„� SQ. FEET OF EACH�'�.nOR: o�' <br /> �O. OF BEDROOtiiS: GARAGE STALLS� ATT. DET.__ <br /> EST�VIATED CONSTRUCTION VAL�JATION (excluding land): ��.000'� <br /> I hereby apply foc a building permi� arld 1 acknowledgc tbat the informatlon above is compiete and <br /> accurate; thst thC work will be in conformatue with the ord'utances and codes of thc City and with <br /> the Stace Building Code; tha� I understa�d chis is not a permit and work is not ta ste�n tivichout a <br /> permit; and thac �he �rork will b�e in accordance with che apptavefl plan. <br /> APPLICANI''S SIGNATURE: �Q�. pATE- �- �' C� O`` <br /> NOTE.' pa�ade nf Homes events reguire separate permft approvacl by Police Drpartrnerad and <br /> G'�ry Counct! d4 days prio�tv the event, Non penrcitted events wil! not be altawed, <br /> 5 <br />