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U3-'27198 12:�6 E�A� 6129�21063 LECF CUNS'I'R[��C'fN I7jUO2 <br /> ',.. <br /> � Total Fee: $ " � Date Received: <br /> Entered By: Permit #: j�- j ,-. <br /> CYTY OF OR4N0 - BUILDING PERMIT APPLICATION <br /> AtI infarmation must be submitted in full before plan review w-ill be starfed_ <br /> (please print all infornurtion) <br /> -------------------------------------------- <br /> THE AppLICANT IS: (circle one) QWNER OR CONTRACTQR A� <br /> J�I3 SITE ADDRESS: 75 5�-ct,� Clr-ee� �c� ZIP: �S�a3 <br /> � N�� Or OWNER: $ �urie �MM�V''S PHONE: (home)�'j��_4�_3�,t3 <br /> (wark} <br /> MAII.ING ADDRESS: b M.,e.a�oc,��•�� � CITY: �'o(��e v�� ZIF:�,3� <br /> -rx. _ <br /> coNr�,cTOR: L C�,,�S�„-�.�t oh �. Pxorr�: <br /> CONTACTPERS4N: sn►�ts I..�rdmar���OBILE/PAGER: <br /> MAILING ADDRESS: Q.3 o V� �lrtq �-. r�- CIfiY: �eh 1 � ZIP: K�n • SS.� -� <br /> STATE LICENSE: # �( � <br /> ARCHITECT/F,NGINEER: S�.m� Czs f��ocv� PHO�IE: <br /> 1�IA,ILING ADDRE55: CITY: ZIp: <br /> NA1��E: REGL571�A.TION 1# <br /> TYQE OF �VORk: New� _ Addition Accessory SLucture x <br /> . Move Remodel/Alteration L,3nd Alteration <br /> , � <br /> PROPOSED�VQRK(descri6e in detaiPJ: a�, 7C ��.� �t�..,�c��y �7t,� �1 c�r nq <br /> _l o r� b u�C* l v� � t�r�v� r�X Q reC��. <br /> STORIES: I SQ. �EET OF EACH FLOOR: � , � . <br /> N�. OF BEDROOMS: GARAGE STALLS: ATT. DE . <br /> ESTIMAT'ED CONSTRUCTION VALUATION (excluding lancl): $ �}� <br /> I hereby apply for a bnilding permit and I ac�:nowiedge that the infonnation above is complete and <br /> accurate; d�t tt�e �vork wili be in conformance with the ordinances and codes of the City and witl� <br /> the State Buil�ing Code; that I understa.nd this is not a permit and work is not to start without a <br /> permit; and that ttie work will be ' cordance wi e proved plan. <br /> APPLICANT'S SIGNA ` nATE: ,,�--�7 `�8 <br /> G�'.ex� <br /> NOTE� Parade of Homes events requir eparate p rmit approval by Police .Uepartment and <br /> City Council 60 days prior to the event. Non permrtled events will not be allowed. <br /> 9 <br />