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� � ' <br /> . Total Fee: $ � . D Date Received: �w �.,��. '� "p' <br /> Entered By: Permit#: 1 � 3 5`3 �- <br /> CITY OF OR NO - BUII.DING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. . <br /> (please print all information) <br /> THE APPLICA�'T IS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS: � -� �-(�' ZIP: <br /> NAME OF OWNER: � C�1 PHONE: (home) �-/7 �^���� <br /> (work) <br /> 1�IAII.I�i iG ADDRESS: — �_CTTY: �'jYO� C� ZIP: <br /> CONTRACTOR: 6 � PHONE: ��{I 't�C� � <br /> CONTACT PERSON: OBILE/PAGER: <br /> MAII..L�'G ADDRFSS: CITY: L ZIP: c��/ <br /> STATE LICENSE: #�"�2c�� S S-(o b <br /> ARCHITECT/El\'GINEER: PHOi�TE: � <br /> iVIAII..ING ADDRFSS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition essory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detai�: 2 12.Iap� -- -��c�'C �T � � $Q <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: _ATT. DET. <br /> ESTII-i IATED CONSTRUCTION VALUATION(excluding land): $ �� �9�7• v� . <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 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 /> APPLICANT'S SIGNATURE: _ DATE: ���Pr� <br /> NOTE! Parade of Homes events require separate permit approval by Police Depariment and <br /> City Council 60 days prior to the event. Non permitted events will not be atlowed. � <br />