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„� � � � , � <br />"� Total Fee: $ _�L� � � Date Received: 3-�-�'� <br /> �.1�h� Q� <br />,,j� ����”Entered By: ,�-' L � '� Permit#: �'1-� `�'� i <br />� i� � <br /> r�v� LG����z�f <br /> CITY OF OR( �� VIIT APPLICATIOleT <br /> ---� /� ��i � � i_.i7 (�.{ , <br /> � -- <br /> All information musi pe sunmitted 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: ��� L ����'� L�uU L� (�� ZIP: S� 3� � <br /> NAME OF OWNER: �hP;�1 f`th�� , �`'�''5��� PHONE: (home) y 5�- Lf 7�_3 c�� ,� <br /> (work) <br /> MAILING ADDRESS: ��`� l-�/�l-l�,✓v�� ,� CITY: r'�►uviv�7 ZIP: 5'S Jc..� <br /> C0�ITRACTOR: � �`�� PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: �� PHONE: <br /> l�ZAILING 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�.�--�� �i —S�� <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ <br /> I hereby apply for a building pernut 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 City 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 /> �, <br /> APPLICANT'S SIGNATURE: , � `�ATE: -�-� �- � �' <br /> NOTE! Parade of Homes events require separate permit approval by Police Deparlment and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />