Laserfiche WebLink
C' <br /> � T4ta1 Fee: $ � � G��1. � � Dat� Rec�ived: <br /> �itered By: �� Permit#: � '�(�S <br /> �, <br /> CTTY OF OR4N0 - BLZLDING PERMIT ,A.PPLICAT�ON <br /> All information must be sa.ibmitted in full before plan review will be started. <br /> (please print all information) <br /> THE APFLICAN'i' IS: (circle one) OWNER OR CONTRACTOR <br /> JOB SITE ADDRESS: l��� �v� ,��rc�� Zn': <br /> NAME OF OWNER: (� •�������� ��//�ONE: (home)�- 73 - 3�°� <br /> / (work) /2- �. — /o <br /> NIAII.,IitiG ADDRESS: ��1GlJ�s cc�on d ��.. CTTY: o ZIP:�y���'� <br /> �r��-�1 <br /> COI\TR.ACTOR: � v o PHONE: �o�aZ � - a _ <br /> CONTACT PERSON: � � ' ,�' ��t�10BILE/PAGER: /a.. - � // <br /> NiAII.Il�,'�ADDRESS: S � C�'i'X: �T , ' � ZIP: s iG Z3Sa <br /> STATE LICENSE: # ocx�a,(, Sy� _ <br /> ARCHITECT/ENGTi 1EER:�_ PHONE: ���-' q�-�—��-�f� <br /> 1V�A�LING ADDRESS: S' / : 5T�,o�ia �� ZIP: � /(o <br /> NA.NS�: U�a��.e T �ra_ REGISTRATION# 2 3 S � lo <br /> TYPE OF WORK: New Addition�_ Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK�describ in detain: �-r � � <br /> . � <br /> STORIES: � SQ. FEET OF EACH FLOOR: /O�v G��4 c .��j,3 <br /> NO. OF BEDROOMS: G.�RAGE STALLS: ATT. �_ D <br /> E,STIVIATED CONSTRUCTION VALUATION (excluding land): $, /�O,doc� <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.nce with the ordinances and codes of the City and with <br /> the State Bui�ding 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 a or c with the approved plan. <br /> APPLICANT'S SIGNATLTRE DATE: I O <br /> NOTE! Parade o Homes events requir separate permit approval by Police Department and <br /> City Counci160 days prior to the event_ Non permitted events will not be allowed. <br /> 9 <br />