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O � <br /> ' Total Fee: $ --5� � Date Received: $���--v� <br /> Entered By: Permit#: O �,$ (�� <br /> °� CITY OF OR NO - BUILDING PERMIT APPLICATION <br /> �� <br /> All information must be su6mitted in full before plan review wi116e started. <br /> (please print all information) <br /> ------------------------------------------------------ - ---------------------------------------------------- <br /> _.� <br /> THE APPLICANT IS: (circle one) OWNER O CONTRACTOR <br /> JOB SITE ADDRESS: 1�17 �, �d✓1 � 2 � ZIP: �_'3�7— <br /> NAME OF OWNER: ���Z�� ��`�/Z�3 PHONE: (home) �v� ��o��� <br /> (work) ��� — � ` � <br /> MAII.ING ADDRESS: CITY: ZIP: <br /> CONTRACTOR: PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: /V D N c� PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION# <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration Land Alteration_�_ <br /> PROPOSED WORK(d scrib in detain: i/� ' ��� � � /'z�- ���—� <br /> a �'��� ,2�� �j/'`� -- �- i li �� /e / z� <br /> STORIES: SQ.FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> o � <br /> ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ 0��8� <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 ' e ordinances and codes of the City and with <br /> the State Building Code; that I understand s ' ot a pemut and work is not to start without a <br /> permit; and that the work will be in ac r ce wi approved plan. <br /> APPLICANT'S SIGNATURE: DATE: �3 � <br /> NOTE! Parade of Homes events require separate perm' approval by Police Department and <br /> Ciry Council 60 days prior to the event. Non permitted events will not be allowed. <br />