Laserfiche WebLink
Total Fee: $ 3 Date Received: !'�� <br /> Entered By: Permit #: <br /> CITY OF OR4NO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS: 2OPo ZIP: <br /> NAME OF OWNER: PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: �3�y �•�e+tbe� A-� S. CITY: c9�t.o�►� ZIP: <br /> CONTRACTOR: 4 PHONE: 76 3-56o-eoy8 <br /> CONTACT PERSON: P,,,A ffi. MOBILE/PAGER: <br /> MAILING ADDRESS: Woo7�'—`'��- �:r�h CITY: Ba_k�g, A-A1< ZIP: 55-0e/ <br /> STATE LICENSE: #1C -oo Sr? <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New X Addition Accessory Structure <br /> Move Remodel/Alteration X Land Alteration <br /> PROPOSED WORK (describe in detail: <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 8�d OO ' <br /> I hereby apply for a building permit 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 the <br /> State Building Code; that I understand this is not a permit and work is not to start without a permit; <br /> and that the work will be in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: -�C -A DATE: <br /> NOTE. Parade of Homes events require separate permit approval by Police Department and City <br /> Council 60 days prior to the event. Non permitted events will not be allowed. <br /> Ff A, 4, 0AP110 Cvyly u nr i'7 n h Ce.•-�oLc �o�J <br />