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' Total Fee: $ � Date Received: <br /> � Entered By: Permit#: <br /> CITY OF OR�NO - 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 OR CONTRACTOR <br /> JOB SITE ADDRESS: � �'I'Zo �,�4,E'Yl- ZIP: <br /> f�-��-�: i`� <br /> Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? <br /> ❑ Ye5 �No If yes, a specia!event permit is required with Police Department and Ciry Counci!approval <br /> 60 days prior to the event. Shzrttle baas service will be required unless applicant demonstrates <br /> sufficient on-site parking is availab[e. Non permrtted events will not be allowed. <br /> C;LrLC. ��2- 2Z.� � ��80 <br /> NAME OF OWNER: ,dts� `� C c�e.j s S PHONE: (home) <br /> (work) <br /> MAILING ADDRESS: I�'ZD �sG�G_i2-a�SS �t'i CITY: �n ,;_, � ZIP: <br /> CONTRACTOR: �p�� �g;l�y.���c���.�y..�,�r�f?t,� i►�►C�HONE: (��z-7�-l-)�--(v�`� <br /> CONTACT PERSON:-�j�� �,�G�i g�� MOBILE/PAGER: � <br /> MAILING ADDRESS: �� t n 2 3�{-� �.i.� lJ t CITY: S i�.� ZIP: 5 So'J� <br /> STATE LICENSE: # Z o 3 �,5'3�{- � EXPIRATION DATE: 3 -2� _�.,� <br /> ARCHITECT/ENGINEER: - PHONE: <br /> MAILING ADDRES5: �—'- CITY: ZIP: <br /> NAME: ��---� REGISTRATION: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home Remodel/Alteration (ie: Siding, Windows) G <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK(describe in detain: �'ow�,��-e�-i� S�O:,J G,� S�isrz,�Fr� <br /> _�`��-_ rw�� 0 l.J r-J �.N- <br /> STORIES: Z SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED <br /> ESTIMATED CONSTRUCTION VALUATION(ezcluding land): $ '�p d� <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATU� DATE: -� 6(v�-p� <br /> 31 <br />