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Total Fee: $ � �"�' `�� Date Received: ��/3o�U�� <br /> Entered By: _ Permit#: ���-�/ �-- <br /> CITY OF OR�NO - BUILDING PERMIT APPLICATI0�1 <br /> All information must be submitted in full before plan review will be started. <br /> (please�ri�zt all infor�nation) <br /> ----------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (cii•cle o�ze) OWNER OR CONTRAC . <br /> , � � <br /> ,�!��� <br /> JOB SITE ADDRESS: �-- �� � I�!" ' <br /> .� �� �_ f � l <br /> � s � � <br /> �Vill this be �a-P�/�rade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ I'eS I �(I iv0 If>>es, a special ei�er�t pernzit is�•eqz�ired tivith Police Depnf•trr�ei�t arrd City Cocuvcil npproval <br /> T 60 days prror to the event. Shutt(e birs service x�ill be��egi�ired urzless applica��t c�emorasd�ntes <br /> sufficient on-site prn�king is available. No�-perrnitted events rvill not be nllowecl. <br /> . -,. f ,�Q <br /> NAME Ok'OWNER: ��� �� �� PHONE: (home) ( �v �'�� <br /> � � -' (work) , <br /> ' L - _ <br /> ��.�� �-��-.� � �� � . - <br /> MAILING ADDItESS:,.� • - <br /> CONTRACTOR ����� PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP; <br /> STAT�LICENSE: # EX�IRAT'IO1V DATE: <br /> ARC�-II'I'ECT/ENGINEEIZ: PHONE: <br /> MAILTNr ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORI{: Ne�v Hom-c Addition Accessory Structure <br /> Move Home Remodel/Alteration (ie: Sidin�, Windows) <br /> P12 PQ,SEI)� RK(describe i�i detai : � �- + � <br /> �� � � ` � � - <br /> � � <br /> � <br /> S'I'ORYES: �_ �Q.�'�ET O�Ef1�I�FL,001�: � ��`3 <br /> 1�10. OF BEDIZ001i�IS:� GAI�AGE S7'ALLS: A'I"'TACI-�EI) I)E'g"�C'�IEI➢_ <br /> �ST'I?!'IA'TEfi�C'0�1ST'1�i1C'T'I0�1�'���1�'Y'IOI�i(exc�uclir►g land): � <br /> �.!�[= UU, c� <br /> I hereby apply for a btiilding permit and I acknowledge that the infoi7nation above is complete and accurate; <br /> that the work will be in conformance with the ordinances aud codes of the City and with the State Buildin� <br /> Code;that I understand tl�is is not apennit and���orlc is not to start w� hout a pennit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLIC��'�''S SIGIVA'I�iJRE: _ , �� � ,�DA'�'E: � ��� <br /> 31 <br />