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Total Fee: $ �z ' � ��' Date Received: ��(�- �'� <br /> Entered By: I- �'''7 i �ernut#: C; r /c � <br /> �-= �j`��:� �-� L--/ c ��< <� <br /> CITY OF OR��NO - BUILDING PERNIIT APPLICATIOIeT <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> --- --------------------------------------------------------- --------------------------------- <br /> ---------------------- - � <br /> THE APPLICANT IS: (circle one) OWNER OR ONTRACTO� <br /> JOB SITE ADDRESS: ;�7�S C c�,r,��u,�c,/s�,�I _r �' G�f�T ZIP: .S����' <br /> NAME OF OWNER: �.�<�i /U,lJI-f����n PHONE: (home) 9�:3 -j17�---���"`1 <br /> (work) <br /> MAILING ADDRESS:.�7 S� �����js��J� CITY: pfZ�� � ZIP: �5 � <br /> CONTRACTOR: �2�S i7 E-f `�Yr S PHONE: �, S`l- ���'zC}-( ��`� <br /> CONTACT PERSON: r,'-�-r�,I�<✓�'c� MOBILE/PAGER: �/G- J��-'- / Z-31"� <br /> NIAILING ADDRESS: .� � L_� 1�t E Cv��•�+� %�� CITY: �� i=��1��__ ZIP: :a�1 (- <br /> STATE LICENSE: # <br /> AIZCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> N��; REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration�_ Land Alteration <br /> PROPOSED WORK(describe in detai�: ;�C>�c� .���crzv6�G��-✓J � � <br /> STORIES: SQ. FEET OF EACH FLOOR: �� <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ / S�,� �= <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 /> APPLICANT'S SIGNATURE: �� "��f-�- _ DATE: �=��,/'-�Z. <br /> NOTE! Parade Qf Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />