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i � <br /> Total Fee: $ � ����l � � Date Received: f- � °� <br /> � Entered By: /� �`.j' Permit#: -�_`% ��-��- <br /> .�"''4/I'ti;C !✓ -- Jt �' 1 <br /> CITY OF OROr�O - BUII.,DING PERNIIT APPLICATION <br /> �11 information must be submitted in full before plan review will be started. <br /> � (please print all information) <br /> ------------------------------------------------------------------------------------------------------------------- <br /> THF. APPLICANT IS: (circle one) OWNE OR CONTRACTOR <br /> JOB SITE ADDRESS: ��O S:� aJ�'� � ' ZIP: J S"�s G <br /> ys�- <br /> NAME OF OWNER: �p�81 i� 1'�t.�."�'S PH0�1E: (home) �3-4=�� <br /> CQ.QQ- <br /> work)`I2-3"'�� •21 � <br /> 1�iAILING ADDRESS: S��as-- . CITY: �� �.a ILd—ZIP: �s'3.�'Gs <br /> C,4�( `s wh.e^' �L.''-�`� --� 1.,�c�:t: w o 21c =l b3�55'3--?st N <br /> CONTRACTOR: S�� PHO�TE: •�A'!F" <br /> CON'TACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MA.ILING ADDRESS: CITY: Z�: <br /> rJ�,�; REGISTRATION# � <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration�_ Land Alteration <br /> /� <br /> PROPOSED WORK(describe in detain: LC� !'b`•` <br /> STORIES: I SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. � DET. <br /> ��; <br /> ESTII�i IATED CONSTRUCTION VALUATION (excluding land): �_ l�,L�%L' ° _ <br /> I hereby apply for a building pernut and 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 City and with <br /> the State Building Code; that I understand this is not a permit and work is not to start without a <br /> permit; and that the work will be in accordance with the approved plan. <br /> AP <br /> PLICANT'S SIGNATURE: ��+. DATE: �� ��G � <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />