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. .. � , <br /> G,�� <br /> - Total Fee: $ ��/'� �; �� Date Received: �--��-(��� <br /> Entered By: 'K1 ' , ; <br /> � ;'� � Permit#: �A-C�.��O�� <br /> �� f � �i!�` <br /> y�����'. , <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 /> ---------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER O ONTRACTO <br /> JOB SITE ADDRESS: � �=-> �' � /-� � c/ i �-'_C�, �r: �>,_ZIP: <br /> NAME OF OWNER: f��` T � `i�. ,�� c.,v� ,-_�, �-_ PHONE: (home) 7�; .� /�/73 s 3 3 '� <br /> (work) <br /> MAILING ADDRESS: %"3 I �� �= v y �Ge � ;� CITY: ;J r,v G ZIP: <br /> CONTRACTOR: /-{ �; ;���-S y-�1 !3 :: �,�E�y� i3�: /�.� � PHONE: ��,3 H��:' �; cy�'2. <br /> CONTACT PERSON: �.aHr y /��d�,_s ;; .J MOBILE/PAGER: �jz, �G � �,,S� <br /> MAILING ADDRESS: G; s � <� �� � �., S T CITY: ,,_ ;; �.�, ��-,_. � ZIP: �>-S �, c <br /> STATE LICENSE: # ���.: ,�Y ��s <br /> >. <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration ,K Land Alteration <br /> PROPOSED WORK(describe in detai�: _ �., ;; � � /; ,'t�= /z � _.., -> � f :: � 7` <br /> ,`, } 1l. .i C_., - �',v i` C �. t.s;.--. ..� �. ,� �/ <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTLVIATED CONSTRUCTION VALUATION (excluding land): $ `) �: �� o •�� <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 Ciry 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 /> ; � <br /> APPLICANT'S SIGNATURE: .'� ;;�.t.�1 �:�(�i-�-�,�.�,--_ DATE: ��_ .:Z. -v Z--- <br /> ,�; <br /> NOTE! Parade of Homes events require separate pernzit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />