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,• <br /> = Total Fee: $ ;r�`��%�, ` -- Date Received: .y"L'-/3 � �=:1 <br /> Entered By: �:;y�r� Permit#: �c��{ � � � <br /> � f� 1��Y� ,�.J {/�j l�(. )_ <br /> CITY OF ORbNO - BUILDING PERMIT APPLICATION <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 O CONTRACTOR <br /> JOB SITE ADDRESS: ��`�1 ��,���a w�� �- i2� ZIP: 5 53'�( <br /> NAME OF OWNER: �c:�:� P��rn� tZAG�rn p c���� PHONE: (home) �_��=����,. p ci 9 0 <br /> (work) <br /> MAILING ADDRESS: i���1 F;�t,r:�.rvv� �1'�rc� CITY• �,_���� ZIP• ��3`�f <br /> �(k'La,.,�) <br /> CONTRACTOR: �N6 C-ARxQC>�,�U�� C.�N`��.��i�w�• ��,,` PHONE: ��-c��1--5 7(S <br /> CONTACTPERSON: �;,�,; p,�;;�,,� MOBILE/PAGER: F,2• �S�R- 2.E,y(, <br /> MAILING ADDRESS: �;,�� � �2.�, �c� CITY: p�c�;•,� ZIP: ;�3G W <br /> STATE LICENSE: # 7,��-�. <br /> vl2r�F i S f.t,A;� <br /> ARCHITECT/ENGINEER: G.2�,� R�•.;c,� PHONE: ��a��i��..- ������ <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration�_ Land Alteration <br /> PROPOSED WORK(describe in detai�: �;r;, ,�,Tc��� �}��,i,��;�5 _ C�IAr.;aE. r� �j w.��:��� +�t�' <br /> � i� K, <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 2 S uc� �-' <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: � � <br /> _� i��� �ti���z-� DATE: a.,s-p i, <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non perntitted events will not be allowed. <br /> 5 <br />