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��io-rou-uuzu � < <.��y ui LC�tiyiiini� rciiin�nNN�i�,auv�� • -•- - - • -- - - <br /> ; Building Department_ <br /> ` � M o..i 6 c,A <br /> )atE�Rocelved r �� ' I Ph�one.Contact f.or Permittin �l 3 26q __ �"'j� �g' <br /> za�r� ' � ;� � <br /> )wn�:r's Name l�c^t-�� �7�lM, 5`=�.�� Owner Phone Number ��1 '� 7 Z� ��r7S2 <br /> _.T..�_ <br /> hrvnE�r's Address�,s��'''e- , �, � Owner Phone Number Cg�'�� ��'g- 9S7$ � <br /> � <br /> �ee:Nmple Titleholdar N�ame CI_��� Owner Phone Numbe �7�`l-�l5- �7�ZZ <br /> 'ee:ilrnple Tltleholder A�ddress C�� � <br /> � <br /> �-- <br /> ioe��er��i�ess ��r l3/ d�k�"�S7 �,_/�y ZePtiaYh i(!s %L 3 3�"y� ] LOT# /(c= <br /> �uESi�ivisioN ��A ic. C.dt.e ',S-i .�__� PAR�EL ID# D�--Z�-2r -�z3 t� --ovoop -a r�o � <br /> � (OBTAINED FROM PROPERTY TAX NOTIGE) <br /> NOR:6C.PRORO.S�� �NEW�CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> B �INS�ALL E� REPAIR <br /> �ROFOSEED.U3E [� iSFl�t) �� COMM � OTHER <br /> r1fF�l:�F CONST�tUCTIGiN [� i8 F _ TEEL <br /> �—. <br /> DE3�FtIP'�ION Of'WC)RYC r�-�Ci4 � � - ^r2 GrN�`7`r�� -o w Sic���e"i _ �- SZ2$,7 � <br /> BUIL.I�INGi S�ZE C_ '� SQ FOOI'AGE HEIGHT � <br /> [m�S�7�LJ A� i3i�t � <br /> �_� BUILDING $ r I I� VALUATI()N OF TOTAL CONSTRUCTION <br /> /� � D � <br /> �_�ELEC7RICAL $ ! AMP SERVICE Q PROGRESS kNERGY �] W.R,E.C, <br /> C� � � <br /> �_�PLUMBING $ , J <br /> � C�- '�� �z;� <br /> �__ � <br /> [�MECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION <br /> �GAS Q IR017�FING �] SPE(,IALTY [� OTHER �l `�� I <br /> FINISHEG FLOOR ELEV��TIONS ��—�1 FLOOD ZONE AREA QYES NO <br /> �__�__� �. —�"_P C� r�,e�^ �...�::�.;•, <br /> tttro-t-tt�-rrrrttrtitttttt ;ttttt�-ittt+rrrrt, <br /> ^�' �'/O PAPIY ��4J-eS==ldoM�e, CeN�T�er�-,�o�.�. <br /> BUIl.DER • <br /> SIGiIV�TURE `� FtEGISTERED Y/ N FEE CURRE� ��/N <br /> --i <br /> ) � I e��j �"�'A �(u1� 3 z-�3 7"�' License# C.�o�. � J�1 ��� •�__� <br /> ada�ess �o Qo � '1 �l�_� � � , <br /> =___. __ .s= <br /> : , <br /> ELECTRICIAN � � (;OMPANY <br /> SIC�NATURE � <br /> � FtEGISTERED Y/ N FEE CURRE� Y/N <br /> — ',— , _� <br /> Address C_ ;�_� ' � License# C <br /> r--�_—^.-- <br /> — � <br /> PLI�MBER i � � 1:OMPANY <br /> SIGWATURE _ ��,� � ftE01STERED Y/ N FEE CURRIS� Y/N <br /> ; �— � � r� <br /> R�ddress C_ i__„� -_ ' License# C <br /> ���— � _� <br /> MEEI:kIANICAL � I;OMPANY <br /> SIIiNATU6tE � REGISTERED Y/ N F6E CUFtRE� Y/N <br /> � i=;�- i � <br /> �dd�ess , _ Llcense# � � <br /> M� � <br /> 01'N�R ! � i 1;OMPANY <br /> S1�3NE4TIJRE i_^ I ftE01STEREp Y/ N FEE CURREA Y I N <br /> _ , T'—� ' � _� <br /> � � I L(cense# [ <br /> Address C_, ! -��------� <br /> {{..�{_�¢{�-�.}.f{�-f}i-}t}}f}} f'htff�ti�ttti-tl'tti'ti-f'titti-Ft' f-Ftti <br /> RE:�IF7ENTIAL Attach(2)Plot Plans;(2 setslof Buliding Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon, <br /> � Stormwater Plans w/Sflt Fence Installed, <br /> Minimum ten(10)workl �g d�� s after submitkal date. Requlred onsite, onsWctlon Plans, <br /> - S�nitary FacIllUes�1 dtiimp,��er;.Site Work.Permlt forsubdivlslonsllarge proJects __.__ <br /> - Cc)MtlVIERCIAL Aflach(3)complete sats,•of�9ullding Plans p'us a Llfe Safety�Page;-(1)sef of Energy Forms.-R=O=VV Pem�it"f-o`r new consW�tlon�-` - <br /> • '�Minirnum ten(10)workir�g df�ys a fter su bm l t ta l da te. R e q u i r e d o n s l t e, C o n s t r u c U o n P l a n s, S t o r m water Plans w/Sllt Fence Installed, <br /> Sanll:ary Facllitles&1 dy�mps er,Site Work Permit for all new proJects.All commercial requlrements must meet compllance <br /> SIGiN PEERMIT Attarh(2)sets of Engin��ere�i Plans. � <br /> ""'PROPERTY SURVEY re uired for all NEW constructlon, <br /> acan�n�tnrm�n� � <br /> Dlrectlons; � ` i <br /> FIII out applicatiun c,rompletely, ; <br /> Owner&Contractor slgn back of appll�;atlor�,notarized <br /> If over 52500,m Notice of Commenc��ment Is requlred.; (AIC upgrades over 57500) <br /> •' Agont(for the c�mtractor)or Power of E�ttomi y(for the owr;Ser)would be someone with notarized letter from owner authorizing same <br /> OVF�t THE COUNTE:R IPERMITTING '(f'rur�t of Applicatlon Only) <br /> R�eroofs Ii shingles Sewers Servjce U grades A/C j Fences(PlotlSurvey/Footage) <br /> i <br /> Driveways-Not ovi3r Counter If on public ro dways,.neE�dsl ROW <br /> � I <br /> �� ' i <br /> / I <br />