Laserfiche WebLink
� .1-20�Z 10:�2am From-ClTY OF OR�fO +9522494616 T-58T P.006/007 F-Q98 <br /> t-�' . - (, _J .�,�'. <br /> Total Fec. $ -, (a" � �% Date Received: 2� � iG Z <br /> Entered By: � �'/� /' ---. Permit#: <br /> `I�,r"i'y�';� `�/�:j� D y�-7v <br /> �ITY QF QROrT4 - BY3II.DING PE;�T ApPIlICA7'�LON <br /> �AII information must be submrt#ed ut fuII before pian review wiil be stsrted, <br /> � ��\ (please p�int all ircformatiorc} - <br /> � � — <br /> �� THE APP�CANT IS: (circle one) UWNER O CONTRACTOR <br /> , n <br /> � � B SITE A.UDRESS: �L,O J- f 1�10��e K`, c�, �.e �� ,. ZIp: <br /> '� � - -- , r . <br /> NA.M� UF OV�NER: �t`i C 'F,���` S c:u ,.� PHONE: (home}�j�2-¢1<-?�ol� <br /> �'d �v� �work) ,._ <br /> MA�.�TG ADDI�SS:�bU�-l���e � �P CI'�X• � !'o r�c ZI}' <br /> t=--�- = <br /> . <br /> CONTRACTOR:� S-�``�:e..� -�' f�S Se C.�c��i PgflN�9S? -- L{i -5 7�i�-C-�-�i�C� <br /> C 4 N T A C T P E R S 4 N_ _ � - y t M O B Y L E E/P A G F.R�d��) -�c t -�Q�� <br /> 11�IAILING ADDRESS; '��'C� _rv1,:,,� ,�;�,��" Cx1"Y• �?��t.,��.� ZIP:�G�( <br /> ST TE LIC�:NSE: # " � �; <br /> A�tC�fT�C".�'/ENCINEER,: C�a:-��j � , S�-1nSc;,� }�IIOND�`�'S"� -�{ �- �Sa.2�, <br /> Mt�ILING ADDRESS: ��? 3.5�.-✓yl;�n.� ;,� �1u c� CITY: �c�e�GtG���^ ZIP: SS'�. <br /> NAME: REGISTI2ATION� <br /> T'YPE O�' V570Rg: New Addition Accessory Suuctttre � <br /> Move R�emadeUA�teration�, Land Alteration � <br /> PRQp(3SED WURS(descrlhe in detai� ���:�,,..�- `' ,,� �;,� /,S <br /> a ,�,�' ac. �u,=i c,�,e/z —v e� /2'.�%��/�c� S��;`, <br /> .,_ . �� ,.�,��s �rtw-P �w( <br /> STORIES: SQ.FE�T O�EACH�,44R: �(20 c�. c��o C/� - <br /> N�. 4F BEDRO�I�IS: GARAGL STAI,LS: ATT. DET. <br /> . �Cj� <br /> ESTIMAI'ED C4NSTRUCTIQi�T VALYTAT�ON (esc�nding land):� � � � <br /> I hereby appIy for�huil <br /> ding perm.it and I acla�wledge that the infoz�rnation abov�is comgiete aztd <br /> accurarc; that the work wiIl be i�3�onforman�e with the ordinan,ces and codes of ttic City a�,d wich <br /> the State Building Code; that I understand thi�; is not a permit and work is not to stari tvnhout a <br /> Qermit; �d t�hat ttie work will be in accordance with�he approved plan. <br /> A�rLYcarrr�s �IG3�a�- �-�� nA�F• a o <br /> NOTE� P�tade vf�i�mes events reqrdre separute permtt approvral by Po1ue Dep�tinent ur�d <br /> City Caunci160 days prior to the even� Non pernritted e�ents wilt not be aAnwed. <br /> S <br />