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� � �'"'�- � � Building Department �
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<br /> Date I�eceived �
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<br /> •r��•1 . _(� Phoite Gontact for Petittitting �� 7� .-- Z
<br /> �wner's Name �G�'1�Z/G�'T"� ✓`S ��l f Owner Phone Num6er D t��F��'��..�2
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<br /> owner`s Address "3 a',� i t�!��r^'��• ��"t�`�� � ' �uuner Phottie Nam'bef�� �—.-:.�
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<br /> fee Stmpls Titfeholder Name �• ' ` Owner Phoqe Rlutriher�— �
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<br /> Fee SitripteTtleholder Add�Pf.ss'' i � � - •
<br /> JOB ApDRESS �`��� . • .
<br /> � �l.t'Vd'� �'l��. � L:OT-� �� �
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<br /> sUBDIVis1oN. ' • y1 G,w � ' • PARCE�.tD# I� -��'�f'"�Q'�`�'`'��'��Y� .
<br /> ' ' - - ' . � {OSTAlMED EAOM PROPERTY TAX NOTlG� • '
<br /> WOEtK Pt20POSED ' , ' NEW CONST'F2 ADDtALi' Q BtGN Q Mt7VE � ClEMOLlS!-� . .
<br /> " e 1 INSTALL �~REPAIR � .
<br /> PROPOSED US� • [� { SFR , ' �- COMM Q OTh1ER • .
<br /> TYPE OF COlVSTRUCTlON Q � BLOGK � Q FRAME ' [� � STEEL. Q OTHER
<br /> DESCRIPTION OF W(JRK. ' � � �D .� �� � ,�o o� � ' f`"'X 7 �L� �.���1• � � .
<br /> su��c��n��s� - � t sct Foosa�� .L._,.�:_��...� � t�E����r ��
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<br /> ' [� BUILDING $�.. 9,,�" ilAWAI'ION t�F TQ�i'AL CCIIdSTRUCTIOP! �
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<br /> Q 'ELECTRICAL $ - + _ ' �, AMP SERVICE [� PRQGFtESS�ENERGY [� W.R.E.C.
<br /> �] PLlJ1VIB1NC7 $ 1 ' ` • �j . �
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<br /> Q MECHA�IICAI.. $ � � ` � ' VqLUAT101V;OF MECHANiCAI..iNSi"�lt_LATtOtV ���
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<br /> Q � GAS r., , [� �� ROO�iiVG- ,Q . SPECIAL3Y Q `03NEF2- , � - j��1Y�\� .
<br /> FINISHED FLOOR ELEVAT ONS i ' _ FLOOD ZONE AREA , Q'YES` ' �ONO '`�
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<br /> � S G'NATURE � C �•�. � ��r'"" COMPANY G�LL�w{40 Bs^ /`5 •
<br /> R��ts�� Y i N �� '�cuR�r .Y=i N
<br /> Addtess v`'��� ��� �' .�`: i�' .�r,�/� . ' � . License# � r�`�•�
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<br /> E�ECTRICIAN. [ � � ' `�`COMP�AfiIY - - -- -- - - --
<br /> S1�NATt7RE (' it���si�Ea ' Y! N _ : 'FEE ctlRt�tr - Y/N� .
<br /> �Address. - � � ' � � x • License# �� - I
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<br /> PLUMBEit `' . � ' �c , CdMP.�INY � ` -
<br /> SIC'aNATURE• ' I t�E�lsTERED Y! (�! �E CURR�NT ' �Y/N
<br /> Address I. . ' _. ' ,, LICe17S8# � �
<br /> MECFiANIGAL , � , , . ' COMPANY �� . .,, _
<br /> � SIGNATURE � - � �REGIS7'�q Y 1 I�1 , F'EE CURFiENf ' Y I N .. � . .
<br /> Address � . • . • ' , , .LiGense# ��—� �
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<br /> ._.. OTHEl�" . ..._�__.. .. ` • ' • �,
<br /> SIGNA'TURE t ��;� __ _..�_..___ _.�.__ . ���s��o ' Y/ N FEE CtJRRENT • -----
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<br /> Adciress � ' � License#k •�� . 1
<br /> RESIDENTIAL Attac�(2)Pla Plans;(2)sets of Building Plans;(1)set of�nergy Fortns;R-0=W Permit for new construcUon,
<br /> . . ,.Minimum,ten. „o)working,days after submittat date, Required nnsite,Construciion Pians,Stormwafer Plans w/Silt Fenoe installad,
<br /> :r� -� Sanifary,Facili es 8�1.dumpsteY;StEe Wortt F'eri�i4t for sra6clivist+ons/tacge projeots .�
<br /> COAI!lNERCiA� ,Attac�i,(3j.co glete seLs of Building Plans plus a.'Life Safety Page;(1)set of Energy Forms.Fi-O-W Aermft far new construeflon.
<br /> �Minir�um fen �10)working day's after sdbmittai date. Requtred onsi#e,Gonstruc6on Plans,Sforinwate�P#ans w!Sil:Fence inst"alled,
<br /> Sani�ary Facil'�es�1 dumpsfer.S�te Work Pernzit for ali new projects:A!!c.�mmerciat req�irements m�tst meet cotnpllance
<br /> ' SIGN PERMlT Attar�h(2)set�of Engineered Plans. ,
<br /> "*"*P�tOPER'i'Y SUFtVEY rEquired fqr all NEW�.consWcbon. • � -
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<br /> Llirectians: . ! • . � � . . � -
<br />, Fill out applica8on complekely. � �- ' • " -
<br /> i � OWner 8�Cantractor�ign b�ckta.f appiicaUon,nofarized � - � . F � - -
<br /> if ove[$2504,a Noti�Ce af Gofnmestaement is required. {A/G upgrades over$5000) �
<br /> `" Agent(far the contraetnr)ta�P i wer o�Attac�ey{for the ovmer}woutd be someone with notarized lekter from oumer authodzing same -
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<br />� DVER l'tiE GOUN'1'ER PERMI'�! G (Fror�t of Applic�8ort O�ly) •
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<br /> Reroofs Sewers Service Upgr�des AlC Fences(PIotlSunreylFootage) - .
<br /> Drivaways-Nat over'Gouiiter E on pubuc ioaiiways.:neeiis Rov1i , � ' 'J- � , � •
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