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. <br /> � i <br /> C,C-. <br /> Total Fee: � .`-, �/ =��� � � t Date Received: �•/.3�p� <br /> Entered By: j Permit#: Ab 959 g,_ <br /> � CI'i'�Y OF OR03V0 - BUILDI�IG PER.��IIT APPLICA.T`ION <br /> ��U�a - ` <br /> ��j� All informa�ion must be submitted i.n full before plan re�ciew�-ill be started. . <br /> � (please print all inforncation) . : <br /> T�FIE APPLICAi\'T IS: � � (circle one) . Oti�N�ER O C NTBAG'FOR � � . . � . <br /> JOB SIT'E ADDRESS: � � � � ��'� x � r ZIP: 5�3�� I <br /> �TAItiIE OF O���R• I�-�' ��r"� L. y ���';6[�,�-Z�r�� c�r PHONE: (home)�� � `� 17 � �(`7/�`� <br /> � (work) �`� Z ��� ��d f�� <br /> i�IAII�ING ADDRESS: C�—t—�-`�� CTI'Y: ZIP: <br /> / / , �� � -�� 2��.� <br /> CONT'R4CTOR: G� G� 1l�c:.�."i9�'� �����d� �i'��L�/pFiONE: ��� � <br /> L <br /> CO�°TACT PERS ON: �� !��� �t�e�' �-� NiOBILEI�L ��- 7�'``t° `� <br /> �v1AII,I�'G ADDRESS:� �- "���/ IIL� L,���y�� i u-c� CTi'Y: �.����t l�c���`�'� ZZP: ��'�5� <br /> STATE LICE�TSE: # ��,3� � <br /> ARCHITECTFE�TG .T�i TEER: �� QG"�'� PHO�'E: —7(Q3—S��-35 I.�Z- <br /> 1�I.AII�I�TG ADDRESS: I S �a� 44�^ 1�1- _CTI'Y: ZIP: _ �� <br /> �T��; REGIS TION� <br /> TYPE OF ti�ORb: New Addition � Accessory Structure <br /> Move Remodel/Alteration X Land Alteration _ - <br /> , < , <br /> �� <br /> PROPOSED'SYORK(describe in detai�: �}c � � `������� �'��� � <br /> nM-&..��, � `�`' ,1�,���^� - ��� - <br /> S'TORIES: /� SQ.FEET OF EACH FLOOR: <br /> NO. OF' BEDROOl�IS: � GAR.AGE STALLS: ATT. -D�' DET. Z� � � . <br /> = . � . _ � <br /> ESTIi1�7A'I'ED CONSTRUCTIO�I VALUATIO�t(excluding land): $���� ��� � � <br /> I hereby apply for�a b �ldin�permit and I aclrnowledge that the information above is complete and <br /> accurate; that the�rork will be in conformance with the ordinances and codes of the Ciry and with <br /> the State Build��� Code; that I understand this is not a permit and work is not to start without a <br /> � pernut; and �t the work will be in acc.rdance with the approved plan. <br /> �-,���-�� �7�'�'� <br /> APPLICA���''S SIGI\TA'ITURE: ��U l� d��'��--�-�-�.� D�.TE: �� -� 9 ��o <br /> � <br /> NOTE! Parade Q Homes events require separate permit approval by Police Department and <br /> � City Counci160 days prior to tke event. Non permitted events will not be allowed. <br />