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r � . � �� �� <br /> 0 '1 � ' � ; , � , <br /> Total Fee: ;�$ � � �`��� -.�� Date Received: � ���"�-C.% -C.:3 � <br /> Entered By: ,�,;,' n i � ��t ,�` ���,'� Permit#: ���'.'�p �� <br /> �� � ry �:___, � <br /> CITY OF OR�O - BUII.,DING PERNIIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICAIV�' IS: (circle one) OWNER OR CONTR.ACTOR <br /> JOB SITE ADDRESS: ��p�� .51�c�„'�(' l i1�,Q �,1,� ZIP: �j3�( � <br /> NA1�� OF OWNER: �i� ����� PHONE: (home) <br /> A work) <br /> MAILING ADDRESS: � �� � ;, �.t,� �'�u.�ITY: ` ZIP: 5�" tl <br /> � <br /> COV`TRACTOR: ���C�('0(,�� ��y.�C_ PHONE: ��L� �0� ����5 <br /> COr�'ACT PERSON:�' �1 � NIOBILE/PAGER: �_(D� t S�' `' <br /> NLAII.ING ADDRESS: - �1 CITY: �A� ?c�Z\ ZIP: ��� <br /> ST�iTE LICENSE: # ���`�_ YV� <br /> ARCHTI'ECT/ENGINEER: PHO�TE: <br /> MAII.I�i 1G ADDRESS: CITY: ZIP: <br /> NA.1IE: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure /� <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: � C� �-�i��.r� CiC c� �T5`�,(C,�i,t,�.-� <br /> � '�.-e�1 <br /> STORIES: y,� SQ. F'EET OF EACH FLOOR ���( X�-�� <br /> NO. OF BEDROOMS: � � GARAGE STALLS: ATT. DET.� <br /> ESTL�IATED CONSTRUCTION VALUATION (excluding land): $ �(� ,n��°� �,C,�Y�'L�JC <br /> �e�:i� �c� � c_c�-t i��u� �•Go b i d� <br /> I hereby apply for a buildin� permit and I acknowledge that the information ab�e is complete and �P�'; <br /> accurate; that the work will be in conformance with the ordinances and codes of the City and with <br /> the State Buildin� Code; that I understand this is not a permit and work is not to start without a <br /> perm.it; and that the �,vork wiTl be in accordance with the approved plan. <br /> APPLICAlVT'S SIGNATURE: �� �(;�t� �U�,(,�,C.�lL,� DATE: �'(,� ���� � �U—� <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Counci160 days prior to the event. Non permitted events wi11 not be allowed. <br /> 5 <br />