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<br /> . Tc�tal Fee: $ �)� .���' � Date Received: `f-� -U/
<br /> Entered By: ;'-�7/� ; ;` ,, Pernut#: �L� 3 4�� 7
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<br /> CITY OF OR�NO - BUILDING PERNIIT APPLICATION
<br /> All information must be submitted in full before plan review will be started.
<br /> (please print all information)
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<br /> THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
<br /> JOB SITE ADDRESS: •-=�'-,, Z�:
<br /> � • �;�,: ,_.�.;,,�,:, . � _ _ , ,
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<br /> NAI��E OF OWNER: �I Ipcl��� ( i�ot� � �`�� PHONE: (home) `��Z-�-I�: � -�-��
<br /> . (work) -
<br /> . , � , _ , .. � .
<br /> MAILING ADDRESS: '��4;�--�, .o l� , _:,�. CITY: -:, .�.,� ,�.,:�t-,�. ZIP: - - , . ,
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<br /> CO\�RACTOR: � ' PHOl�'E:.
<br /> ..�-; . ��1'�'p��I` , ��
<br /> CO`-TACT PERSON: �';Li K�' C urC�.1� ' . NIOBILE/PAGER:
<br /> NL4II.ING ADDRESS: ' , �- �• CITY � .� ,. �_: ,- � ZIP: . '
<br /> / ) _�, x�w''r'. ,.��\`�.L._ '�•a. i
<br /> ST?�TE LICENSE: # ���Z___- '
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<br /> ARCHITECT/ENGINEER• - ' PHO�IE: . � _ . I �f.
<br /> MAII,I�i,'G ADDRESS• - CITY• �,.+ ri'r:<.::. ZIP:
<br /> N�`IE: ;',.; , - :�.; �_ ; ,.. REGISTRATION#
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<br /> TYPE OF WORK: New Addition Accessory Structure
<br /> Move Remodel/Alteration�_ Land Alteration
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<br /> PROPOSED`�ORK(describe in detain: �-=�Y-r-, � . �r�-Y>�,�� �� �� ' ' ��-- 1
<br /> ;�� � � � .�„ti � -
<br /> .-� .
<br /> STORIES: �- ---- SQ. FEET OF EACH FLOOR:
<br /> 1\'O. OF BEDROO�IS: - GARAGE STALLS: ATT. ':_� DET.
<br /> ESTl�IATED CONSTRUCTION VALUATION (excluding land): $ � ��-� � �_�._ .
<br /> I hereby apply for a buildin' 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 wiR be in accordance with the approved plan.
<br /> APPLICANT'S SIGNATURE: �--� DATE: �
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<br /> NOTE! Parade of Homes events require separate permit approval by Police Department and
<br /> Ciiy Council 60 days prior to the event. Non permitted events will not be allowed.
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