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, , �`'� ,���� ' , <br /> _ ?� o � �; <br /> Total Fee: $ � 3 S�S � �� ��FN Date Received: >4 C� � /C��� <br /> , Entered By: �'�� � �'Vfj�'j 5 Permit#: �/Zy/v�,� <br /> �/�7l�"�S <br /> CITY OF OR�NO - BUILDING PERMIT APPLICATION <br /> All informallon must be submitted in full before plan review will be started. <br /> (ptease print all information) <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTO <br /> JOB SITE ADDRESS: ���� l�Gl 'C`VY �CI�I� I�� Z�� <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �NO Ijyes,a special event permit is required with Police Department and City Council approval <br /> 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates <br /> su�cient on-site parking is available. Non permitted events will not be allawed. <br /> NAME OF OWNER: �''�G(I�G{.y P�e hSd� PHONE: (home) �I SZ'�l' 3.S - ��'�1 L <br /> (work) <br /> MAILINGADDRESS: l��i4 f3ct (C�V Y �ICI�cICITY: Grv �� ZIP: <br /> CONTRACTOR: I—l�-121�.�v� Ct9Yt`�T• PHONE: ��Z -,5��-3�7 �- 7 <br /> CONTACT PERSON: �4.v� Lp,�/'{G�� MOBILE/PAGER: 4 r,�,-c. <br /> MAILINGADDRESS: S'1 �Fo �r✓'�CN w�oc� �Y CITY: G-1"P�ytG�o ZIP: s��3 / <br /> STATE LICENSE: # G 3(0 / EXPIRATION DATE: 4 3l�G <br /> ARCHITECT/ENGINEER: CG,r� G.tqw++f N`�'� PHONE: �sl.- `7�,3,3-'�T'.S l v <br /> MAILINGADDRESS: .�"o �a C��1r5Dr�n��G� CITY: /�/Y)h�N�tG. ZIP: .5"S3�S� <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition � Accessory Structure <br /> Move Home Remodel/Alteration <br /> PROPOSED WORK(describe in detain: /�1 W G�cvrz�.g < wt-1�► � /LlwSf�r <br /> ht'G�ro• �y, 5 c�l�t-C O ✓{r C'if�/'�c5 C ' <br /> STORIES: I �L SQ.FEET OF EACH FLOOR: 5�'� G�-Ce r�G $G o �nGI Le� � <br /> NO. OF BEDROOMS:�_ GARAGE STALLS: ATTACHED � DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(ezcluding land): S �1J� oo� i <br /> I hereby apply for a building permit and I acknowledge that the informarion above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: � DATE: �/L 3l�S <br /> 31 <br />