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> ' <br /> Total Fee: $ J� 3 g. �3 Date Received: , `-���f <br /> Entered By: �y12_. Permit#: �� <br /> CITY OF OR � <br /> � ���� ONO - BUILDING PERMIT APPLICATION <br /> � � All information must be submitted in full before plan review will be started. <br /> ��� <br /> (please print all information) <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR <br /> J ZIP: � � - l <br /> JOB SITE ADDRESS: _� �� ��/�/�/J� �L ,e,IJ,�jI <br /> , � �L���� <br /> � � � � � � ����%/���� � � <br /> NAME OF OWNER: f//��.�,�L�G�, �� (�� , � PHONE: (home)(c�,�- ��'�'3���� <br /> (work) <br /> MAILING ADDRESS: ���C�C� ��/.i��l/��� �S�/�CITY: /� � /1� ' ZIP:_��� <br /> /�1�,��iiti� � �l��Gr ' ��'l,f���.lG�/'� � <br /> CONTRACTOR: � f� "� PHONE: ��/���'l=S�I <br /> CONTACT PERSON: MOBII,E/PAGER: <br /> MAILING ADDRESS: - �i ' ll��i�if// CITY: j���/-�L-S ZIP: �S� /� <br /> STATE LICENSE: # �S�T �L/� <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAIVIE: REGISTRATION# <br /> TYPE OF WORK: New ti/ Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: �', �� <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 5 ������ <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 conforma ce with the ordinances and codes of the City and with <br /> the State Building Code; that I underst this is not a permit and work is not to start without a <br /> permit; and that the work will be in,ac rdance wit e approved plan. <br /> ,, <br /> APPLICANT'S SIGNATURE: � DATE: / � � �v�'lG/ <br /> NOTE! Parade qf Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non pernzitted events will not be allowed. <br />