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� Total Fee: $ L��� . �� Date Received: $'-,�p-U4 <br /> Entered By: � Permit#: �n�,t�'7 C� <br /> __�� �� <br /> CITY OF OR�NO - BUII,DING PERNIIT A.PPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> � (please priru all information) <br /> THE APPLICANT IS: (circle one) WNLJ OR CONTRACTO <br /> , <br /> JOB SITE ADDRESS: ! 1 i 1 �i��•-.�� 1J f �v� -•IP: .�_��c-> <br /> NAME OF OWNER: ��uh F�('an c� �'o�-Ct�� �--t-C-PHONE: (home) <br /> (�vark) �.� - �{�,�5� � -1 � <br /> 1�IAILING ADDRE.SS:���� r�uX� CITY: �r C n O � ZIP:����k� <br /> CONTRACTOR: : I�,h n I���t�n c� NcsrneS �'— PHO�TE: �5?-`�73-��-7 / <br /> CO�i'I'ACT PERSON:�.e - -..- MOBILE/PAGER: (n�o� -3 to(o - �4�� <br /> MAILING ADDRESS• ��o �• �i�rki,�x��_CTTY: �;r�n�� �: �'t ' <br /> STAZ'E LICENSE: # 3 5 <br /> ARCFIITECT/ENGINEER: �c:��rr s �rc h,-��'c`f� PHO\�E: L�a -339 -��o <br /> MAILING ADDRESS:33 i Scc n,-,al fEt�1�c ��oo CITY:�4v�s , .�`!/ltii' ZIP: ��O i <br /> NAME: �Jc, �,., ��. �� LT'��a��� }-�ax r,s REGISTRATION# ��� lr D� ' <br /> TYPE OF WORK: New _ (� Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: j� � ,.,-, b 1 e r /n t�-'n� o r''1 e- <br /> STORIES: I SQ.FEET OF EACH FLOOR: �71Ci�r, 19 O l — Lo u�4-r �S9(o <br /> NO. OF BEDROOMS: � r�l�,�r, GARAGE STALLS: ATT�. � DET. � <br /> � W�ue1 <br /> ESTII�i IATED CONSTRUCI'ION VALUATION {excluding land): S �'yS . C�� <br /> I hereby apply for a buiiding permit and I aclmowledge 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 Buildina 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 SIGNA . .�t/}'�� � f���'C� DATE: ��l� ^r � <br /> � ��,`���/d�l�t-��� <br /> NOTE! Parade of Homes events require separate pe{mit approval by Police Deparlment and <br /> City Couneil 60 days prior to the event. Non permitted events will not be allowed. <br />