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Total Fee: $ ,�' ' Date Received: <br /> Entered By: Permit#: <br /> � � <br /> CITY OF ORC��TO - BUILDING PERMIT APPLICATION <br /> ;.. <br /> All information must be�,submitted in full before plan review will be started. <br /> �ease print all information) <br /> ----------------------------------------------'�--------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one` OWNER OR CONTRACTOR <br /> '\ � <br /> JOB SITE ADDRESS: � <br /> �, • <br /> Will this be a Parade of Homes, Remodeler Showcase Home or other D' play Home? <br /> ❑ Yes ❑ No If yes, a special e ent permit is required wit Police Department and City <br /> Council approval days prior to the event Non permitted events will not <br /> be allowed. <br /> NAME OF OWNER: HONE: (home) <br /> (work) <br /> MAILING ADDRESS: CI . ZIP: <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: OBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # � <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CI Y: ZIP: <br /> NAME: RE STRATION # <br /> TYPE OF WORK: New Access ry Structure <br /> Addition Move <br /> RemodeU lteration Land A1 eration <br /> PROPOSED WORK(descr' e in detai�: <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROO GARAGE STALLS: ATT. DET. <br /> ESTIMATED NSTRUCTION VALUATION (excluding land): $ <br /> I hereby app for a building permit and I acl�owledge that the information above is complete and accurate;that the <br /> work wil e in conformance with the ordinances and codes of the City and with the State Building Code; that I <br /> under and this is not a pernut and work is not to start without a permit; and that the work will be in accordance with <br /> the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: <br />