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Total Fee: $ .S'ea a' DateReceived: <br /> Date Approved: <br /> Entered By: e-.dA-J j Permit#: 61'02-1'S' <br /> CITY OF OR(NO - BUILDING PERMIT APPLICATION <br /> ALL INFORMATION MU IT BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL <br /> BE STARTED <br /> THE APPLICANT IS: (circle one) ‘W-7-1E-1.-DOR CONTRACTOR <br /> JOB SITE ADDRESS: S/013-60•®!p7 e:Zyh1 9.7 .AO ZIP: Ss36"6 <br /> NAME OF OWN. ER:.14 L a3 6eK01 y� -1►1 /7 tie PHONE: (home) 1173-ys'yG <br /> (work) 5.0 AV'I. <br /> MAILING ADDRESS: 344< ,zz�.�,!=.v p . CITY:Ae,Jy X,41(E. ZIP: 3S3 5 <br /> CONTRACTOR: PHONE: <br /> MOBILE PHONE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # <br /> ARCHTTECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Remodel/Alteration X Lath Alteration <br /> PROPOSED W/O/RK(describe inddtail): �'�,'r,e</ eD e,,/ y' ,c�joQ..e' - ��jl�L 5d <br /> sL&£i /t0G IL' -/vee cJ �Ous� �/o�' 5 51 D.IN/r i occ - - <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: 3 GARAGE STALLS: ATT. DET. Z <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 025000. <br /> I hereby apply for a building ermit and I acknowledge that the information above is complete <br /> and accurate; that the work w 11 be in conformance with the ordinances and codes of the City <br /> and with the State Building C de; that I understand this is not a permit and work is not to start <br /> without a permit; and that the work will b in accordance with the approved plan. <br /> APPLICANT'S SIGNA -2167c1-4v/ a,— DATE: 8/1//9 <br /> NOTE! Parade of Homes events require separate permit approval by Police Department and <br /> City Council 60 days prior to the event. Non permitted events will not be allowed. <br />