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_ �.� � � ��- �, <br /> � ,.��� -� -��� �'� <br /> Total Fee: $ �` � -� ' Date Received: <br /> Entered By: �� �� Permit#: <br /> _� <br /> � ' y,�,,x-.� /�� _'( " �i / _ <br /> � CITY OF OROI�'b - BITII�D�tG PERIVIIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please prini all information) <br /> TfiE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> 1 <br /> JOB SITE ADDRESS: �`7�� J �L�C���c' X Z�: <br /> �� �� � � <br /> NA1�IE OF OWNER: ,_J Cs i �C� 1��ti - PHO�tE: (home) <br /> (work) <br /> I�IAILLr'G ADDRESS: CTTY: ZIP: <br /> C � PHONE: �5`f G� S I <br /> C0�1'I'R.�.CTOR c.t"��1 1 � c� �: 6'"L <br /> COti�I'ACT PERSON: ��c����,T �c.��-�,---- NiOBILE/PAGER: 7�L% `/y I C{� . <br /> 1�I A I L I�i 1 G A D D R E S S: CTTY: ZIP: <br /> STATE LICENSE: # �a �:� C:' <br /> ARCHITECT/ENGliYEER: _� � �-F.�S��I L PH0�1E: Cc"S I �I� �-� �� �r <br /> I�IAII.II�'G ADDRESS: CITY: ZIP: <br /> N��,�: REGISTRATION# <br /> , <br /> � <br /> TYPE OF `VORK: New �` Addition Accessory Structure <br /> Move � Remodel/Alteration Land Alteration <br /> PROPOSED tiVORK(describe in detai�: <br /> ��# �L �53�3������%�c�� <br /> STORIES: � _ SQ.FEET OF EACH FLOOR: L-C_ �l�U �-�-I� ��a k <br /> NO. OF BEDROOI�IS: ,� G GARAGE STALLS: ATT. _� D E T. <br /> � �- Ct_� <br /> ESTII�IATED CONSTRUCTION VALUATION (excludi.ng lanc�: $ -- ' ` � <br /> I hereby apply for a buildin�permit and I acknowled�e 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 Buildin� Code; that I understand this is not a perm.it and work is not to start without a <br /> perrr�t� �_nd that the work will be in accordance with the approved plan. <br /> � �APPL�CANT'S SIGNATURE: �` � ��, DATE: � �-? � <br /> � <br /> 1�'OTE! Parade of Homes events require sepa ate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />