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. , � <br /> ' Total Fee: $ :�� � r j Date Received:_�/„��- �;'�; <br /> Entered By: ''C Permit#: l���� <br /> CITY OF OR(�NO - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be started. <br /> (please print all information) <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> _�, <br /> THE APPLICANT IS: (circle one) OWNER O�CONTRACTOR • <br /> `iy�':�.� <br /> JOB SITE ADDRESS: ��_, � `� i`-'/��/i�/viv��h/`��'o-ri`Gr't���',ZIP: ��� �� � i: <br /> NAME OF OWNER: �- ,<�U'�z .S�/�•�.�r/ �/��,;'� PHONE: (home)c::�f L - �J��- z'�r"J� <br /> (work) <br /> MAILING ADDRESS: ; ¢i ��i/�.via�!i�,��:��r.�r�ITY: (,,�r2c'.�:: ZIP: ,—; - :.�� <br /> %'-N.`-r- . <br /> CONTRACTOR: ' .. ,��j�C%�"`f'/.�=�=rt C� - /...-�. PHONE:4�.%����'' '`,`% �- <br /> CONTACT PERSON: � ,'�x '���t=.�-�iu'/.����°' MOBILE/PAGER: _ -z - %-��;i���� <br /> MAILING ADDRESS• � :G- �1%!/r�,�-' .���%� � CITY•'-���-sr���i'- �' =� --ZIP � � '.i-` <br /> STATE LICENSE: # �r' ;��' <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK• New 4 Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration <br /> PROPOSED WORK(describe in detain: j���.,��� ra t�;%� ,� ,�� --� �' ���� _ <br /> ' �",-s.��---f..;..:-_�..�.�..,,-�_y <br /> _ , <br /> STORIES: � SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> �` c: <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �- - � <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 /> , <br /> APPLICANT'S SIGNATURE: ;. ;, �� ;, .� -=_�:�� DA'�: `� �� ?��'� —�i% <br /> NOTE! Parade of Homes events require separate pernait approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br /> 5 <br />