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Jul 24 07 03: ZOp Trebil Foundation Inc 3Z09748896 p. 2 <br /> � . �S - ,� �-c,�l <br /> . � C� ` '��� � <br /> - 4 � � C� <br /> � <br /> Total Fee: $ 1 �s� ' Date Received: �� Z�'� � �� <br /> Entered By: D Permit#: � Z <br /> CITY OF ORON4-BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review wiil be started. <br /> (please print all information) <br /> THE APPLICANT IS: (ci�cle one) OWNER 4 CONTRACTOR <br /> JOB S1TE ADDRESS: rI� t�l-I- �1� OQ ZIP: �S-�5�v <br /> Will this be a Parade of Homes,Remodelers Showcasc Home or ot6er Display Home? <br /> ❑Yes �NO Ifyes,a special event permil rs reguired i+�ilh Police Depar[ment and City Co:mcil approi>al <br /> 60 days prior to the evenl. Sh:rl!/e bus service»�i/(be required unless applicanl demonstrales <br /> su�cienl on-site parking is avarlable. ��'on permitted evenls wil/nor be alloN�ed. <br /> NAME OF OWNER: ��Q;S Cl� rl(�..(`1�[�I Lt/.�- PHONE: (home),��I� -�a5'- -�`jrf'31 <br /> � I ' (work) <br /> MAILING ADDRESS: r]�� l-�(,L►�-�' -tG{,Vj1'1 j��. CITY: wl ,ZIP: ,-�a 3� <br /> corrrx�croR: �sse �Trebi 1 ���n� ' � �U�-�rn� rxorrE: 3�c�-��y-$��9 <br /> CONTACT PERSON: -' �31�IOBILE/PAGER: <br /> MAILING ADDRESS: � I,� a � �- CITY: 1�'�l c�e,t� ZIP: (o�D� <br /> STATE LICENSE: # - U� �c�k 9 EXPIRATION DATE: 3-3!�-�0 8 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CTTY: ZIP: <br /> NAME: REGISTRAITON: # <br /> TYPE OF WORK: New Home Addition Accessory Structure <br /> Move Home RemodeUAlteration(ie: Siding, Windows) <br /> Any earth movement may require MCWD review and permits! <br /> PROPOSED WORK.idesctibe in detai�: 1�S�-�,��,�-j�� (� l.1JC�Q�� (���,. �613 <br /> �� U L� V1�(1-�����1 <br /> STORIES: SQ.FEET OF EACH FLOOR <br /> NO.OF BEDROOMS: GARAGE STALL5: ATTACHED DETACHED <br /> ESTIIVIATED CONSTR�JCTION VALUATION(ezcluding land): $ `� ���� <br /> I hereby apply for a building permit and i acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that T understand this is not a permit and work is not to start without a permit;and that zhe work will be <br /> in accordance with the approved pian. <br /> �1n` i 'F � � { <br /> APPLICANT'S SIGNATURE: 'Y (- , � '' DATE: � �� <br /> 31. <br />