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f ' l / <br /> Total Fee: $ _`�� � - � �� Date Received: `������y <br /> Entered By: � L� � �,��P_ermit#: �o �D �.,� <br /> ,�� / �- <br /> CITY OF OR - BUILDING PERMIT APPLICATIOleT <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 OR ONTRACTOR <br /> �� <br /> JOB SITE ADDRESS: �G� �� � �� j /�� ZIP: �,����� <br /> NAME OF OWNER:N � '�- � PHONE: (home) <br /> � (work) <br /> MAILING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: Ca'(�v..C, � � n �ri�� -N'� PHONE: � �� 7�` l 8'q� <br /> CONTACT PERSON: 5� �.�x � OBILE/PAGER: foI Z 3 � <br /> MAILING ADDRESS: "L5 r �, � � CITY: !� � � ZIP: S�:3.5 9 <br /> STATE LICENSE: # � . <br /> , <br /> ARCHITECT/ENGINEER:��1�� �d Gh�iz�c � PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME; REGISTRATION# <br /> TYPE OF WORK: New Addition �,�i� Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detain: C�-�'--�n ��-� �� <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ZC�I��>�' <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 City and with <br /> the State Building Code; that I unders nd this i ot a permit and work is not to start without a <br /> permit; and that the work will be in a ordanc ith the approved plan. <br /> APPLICANT'S SIGNATURE: � � DATE:C� L��'�1 O <br /> NOTE! Parade of 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 />