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Total Fee: $ DateReceived: <br /> Entered By: Permit#: <br /> CITY OF OROI�'O - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please pYint all information) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> Jos sITE an�REss: ��15 l���l� �C t �"��� ,�f� ziP: SS 3S� <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �No !f yes, a special event perrnil is reguired with Police Departnient and Ciry Coarncil approval <br /> 60 days prio�-to the event. Sha�ttle bus service ivill be requirecf unless applicant den�onstrutes <br /> su�cient on-site parking is available. ]�'on-pernritted events wi/l not be allo�ved. <br /> NAME OF OWNER: I�I��� (�0�1� ;r.5 PHONE: (home) �S�-�IG�-1-9810 <br /> (work) <br /> MAILING ADDRESS: S�._ ..b ���,,` CITY: ZIP: <br /> CONTRACTOR: ����c. Ex�i���rs PHONE: `�53.- 4-7�.-"L2S�'�j <br /> CONTACT PERSON: 1�..,1 c.. MOBILE/PAGER: �t-7,- �,"1�J- ,.1`1� <br /> MAILINGADDRESS: �9SQ C� 1'�.-� 2� CITY: M:�-�,r;s�-,� ZIP: ,SS359 <br /> STATE LICENSE: # �03153��`7 EXPIRATION DATE: 3- 31-�� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structuce <br /> Move Home Remodel/Alteration (ie: Siding, Windows). <br /> Any earth movement may require MCWD review and permits ! <br /> PROPOSED WORK(clescribe in detarn: �"�„� ��� c,,..( re r.-r,� • <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �y,c�nn . M <br /> I hereby apply for a building permit and I acknowledge that the infonnation above is complete and accurate; <br /> t11at the�vork will be in conformance ���itl: �dinances and codes of the City and��rith the State Buildin� <br /> Code;that I understand this is not a per it an o• is not t tart without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: DATE: �1'17'n�7 <br /> �l <br />