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. 4 � � I <br /> Total Fee: $ � � � ' � Date Received: � � <br /> Entered By: _�� Permit#: � I�1 � � <br /> OR.ONO - BUILDING PERMIT APPLICA.T`ION � � <br /> CI�'Y OF � <br /> .A,ll in�orma�ion must be submitted in full before plan reviesv �-ill be started. . <br /> � (please print all information) . . ' <br /> � APPLICA.3�TT IS: � � (circle one) . O�TNER OI�`S�I�TBA�.OR:�'' � <br /> TFiE <br /> JOB SI� �.nDxESS: J�� d -s'���/ �'v�/ /�cl Z�: ! <br /> NAI�IE OF OVY��►TER: r�G��f�/\ t�'�'j7� f'c^;_ f(J�� PH0�1E: (home) � �����' <br /> . (work) <br /> IYT.AlI.I�i'G A.DDF•ESS: CIT'Y: ZIP: <br /> � .. ..,� <br /> CONTRAC'I'OR: �I� ��/' G��S� PHONE: rC�� >>�� <br /> CONTACT PERSON: MOBILEIPAGER: <br /> MAILING ADDRESS: �.� I.� I�1 \- �,vc� 1(�U CIT'Y: � ��5�� l ZIP: �� � �- <br /> STATE LICE�'SE: # �� �1 � � <br /> ARCHIfiECT�EI�GI�i TEER: : . � Pt30��:. � <br /> 1�?.A.ILIi\'G ADDkLESS: CITY: ' ZIP: <br /> . NAME: REGISTRA.TIO�T# <br /> TYPE OF ti'VORK: New Addition Accessory Structure <br /> Move Remodel/Alteration _ Land Alteration <br /> �- �---- - � <br /> PROPOSED'F'VORK(describe in detai�: �i��'�' �� r�� �' ' � �"'` ' �'�r����" <br /> STORIES: SQ.F'EET OF EACH FLOOR: DET. � � � <br /> NO. OF BEDROOMS: GA.RA.GE STALLS: ATT. _____ . . - <br /> . . \ � � � <br /> EST .Tl�i iA,TED CONSTRUCTION VALUATION (excluding land): $ �� - � <br /> I hereby apply for a building perm.it a.nd I acknowledge that the information above is complete and <br /> accurate; that the work will be in conformance with the ordinances and codes of the Ciry a.nd with <br /> the State Buildi.n� Code; that I understand this is not a perrnit and work is not to start witUout a <br /> permit; and th�c the work will be in accordance with the approved plan. <br /> J � � ��� � <br /> APPLICAi'�'T'S SIGNA'I'LTRE: .�� f DATE: �� <br /> NOTE! �arade Q Homes events require sep ate permit approval by Poliee Department and <br /> � City Counei160 days prior to tke event. Non permitted events wili not be allowed. <br />