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/ _ �' <br /> Total Fee: $ ��� • ll� J Date Received: ��� ��' ' ` � ' <br /> Entez�ed By: -! Permit#: � �y/ �-; <br /> �-_��"l�C �� U� <br /> CITY OF OR�NO - B DING PERMIT APPLICATIOIet <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 CONTRACTOR <br /> JOB SITE ADDRESS: I�Z� �0�4�S j�0��� �ol+ +� ZIP: <br /> NAME OF OWNER: PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: /�/H/�'I ��fTo m 1�o Me S PHONE: (o Sl-6��'- 9 7.��7 <br /> CONTACT PERSON: �m /'J)�//rn MOBILE/PAGER (�/L �p,3 -Z Z SO <br /> MAILING ADDRESS: 8�Z ._ /v y L�,� e CITY: ��GA� ZIP: SS�Z 3 <br /> STATE LICENSE: # �38 5� �� <br /> ARCHIT'ECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NA1�IE: REGISTRATION# <br /> TYPE OF WORK: New ✓ Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: �D D �Ec K ,-o !�E r,�l ��,c�,572 u eJ'�o•J <br /> STORIES: SQ. FEET OF EACH FLOOR: �!S'oZ <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. .. _. ---------- <br /> ESTI'�i IATED CONSTRUCTION VALUATION (excluding land): <br /> ________.._ <br /> I hereby apply for a building pernut 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 SIGNAT DATE: �-/-�=v � <br /> NOTE! Parade Qf Homes events require separate permit approval by Police Deparlment and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />