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s . <br /> Total Fee: $ /7/. j S Date Received: 9-7-00 <br /> Entered By: Permit#: ko 7 9.2- <br /> CITY OF OR NO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> --------------------------------------------------------------------I------- ------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTO <br /> JOB SITE ADDRESS: ,2 AWIW � /97,-1 <br /> ZIP= <br /> NAME OF OWNER: Ze,*4 �Z PHONE: (home) ?�J•Zy� <br /> (work) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: D 1 73"w, � CITY: groeZIP: <br /> STATE LICENSE: # 3� 7 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detail): l iD�f 1'6eo.01� Ile"-r, e <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ o, /J <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 <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 /> APPLICANT'S SIGNATURE: DATE: 77 Od <br /> NOTE! Parade Qf Homes events requiW separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />