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o�.�-rov-wcv c:ity at Gepriyrt�ilts Pemn'tt Application Fax 8i3-�8b-0021 <br /> ; Building Department <br /> s <br />', te Recelved Phone Gontact far Pornstttfn – <br /> Irner's Name /",i" T / �'�'S �-�'��"' ���wner Phone Number ��J� �lY°� �77� °Z <br /> i <br />� rn�r's Addr�ss .� / f �'�- Owner Phone Nurrtber _ <br /> ia Simpie Titlehalder Name Owner Phone Numbar � <br />,I <br /> �8lmple Titleholdar Address <br /> B ADDRESS LOT# � <br /> ��oiv�siaN � � PARCEL ID# /-� - ��- 0 C�l� - t"/ C10 � 0 D Q O <br /> {QBTA4NED PRQM PROPERTY T,4X NOTtCE) <br /> �RK PROPOSED � NEW CONSTR 8 ADD/ALT �� SIGN Q Q OEMOLISH <br /> INSTALL REPA�R <br /> .QPQSED USE Q SFR Q COMM � OTHER <br /> PE OF CONSTRUCTtON [� BLOCK Q FRAME � STEEL Q <br /> SCRiRI'ION OF WQRK �/� -Z � � 9`'j%/ Up'I/1` <br /> iILD1NG SI2E � � SQ FOOTAGE�,�� HEIGHT �_ <br /> QBU1LDiNG �—� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICA� ��� AMP SE32VICE Q PRt3CaRESS ENERGY Q W.R.E.C. , <br /> [�PLUMBlNG $ ��� (' y� 3 �`��? ��JJ • <br /> l .�'�� <br /> MECHAMCAL $ � � VALUATlON OF MECHANICAL INSTA�IRTiON � �l '�� �� � <br /> ' � s- f�„� ��1. <br /> �GAS Q ROOFING Q SPECIALTY Q OTHER ' � « <br /> IISHED FLOOR ELEVATIONS FLQOD ZONE AREA QYES N� ` ��� <br /> tt,QER COMPANY _ � - - - – --- <br /> iNA�{'URE --- '- REGISYERED ` -� �Y/ N FEE CURRE�i�� Y/N <br /> Address � License# �^ � � <br /> cGTRlCIAM COMPANY <br /> iNQTURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �" � <br /> JMBER COMPANIf <br /> �NATURE REGtSTERED Y 1 N FEE CURREh Y/N <br /> Address License# �� � <br /> CHANiCAL CQMPANY /t r'rj''� ,�tr t_ .O�''Lt-- <br /> NATURE ���S � l/� <br /> v REGISTERED Y! N FEE CURREi� /Ri <br /> Address �7 � GJ f) G�-c�t2. Y/ S' t�icense# ����(_.�(�,7 ���-� ! <br /> fER COMPANY <br /> NATURE REGlST�RED Y/ (V FEE GUFtREh Y l N <br /> IAddress �� L}cense# �� '� <br /> iFDENTiAI Attach(2}Ptat Pians;(2}sets of Butfding Plans;(1)set of Energy Forms;R-O-W Permit for new canstructton, <br /> Minimum ten(SO)working days after submittal date. Required onsite,Construction Plans,Stortnwaker Plans w!SAt Fence InstaNed, <br /> Sanitary Facifitles&i dumpster,Site Woric Perrnit for subdivisions/large proJects <br /> AMERCIAL Aftaeh(3)compiete sets of Butldtng P�ans plus a Life Safety Page;{1�set af Energy Fom►s.R-O-W Permlt far new constructlon. <br /> Minimum ten(1 d}working days'after submiital date. Required onsite,Construction Plans,Stormwater Pfans w/SIlt Fence Irtstalled, <br /> Santtary Facilitles&1 dumpster.Site Work Permit tor all new proJects.AU commercial requirements must rrseet compllance <br /> N PERMIT Attach(2)sets of Engineered Plans, <br /> '""PROPERTY SURVEY required for all NEW construcdon. <br /> ctions: <br /> Fitl out app�lcatlon completely. <br /> Owner 8 Contractor sign back of appltcatton,notadzed <br /> if aver y2500,a Notica of Commencement is required. (A!C upgrades ovor�7500) <br /> Agent(for the cantractar)or Power af Attomey(for the awner)would be someone with notarized letter from owner authorizing same <br /> iR 7HE GOUNTER PBRMITTING (Fronk of Applicaflan Only) <br /> �ofs li shingles Sewers Service Upgrades A!G Fences{PloUSurveylFootage) <br /> Drlvewa�rs-Not over Counter ff an publtc roadways..needs ROW <br />