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_ �- <br /> _% o•t�-�tsu-uu�u l.:liy OT G6p ytT1111S f'��fTlli HPPIICaiI0f1 rax-o�i�-iau-vu�i � <br /> uilding Department /�/(��{ <br /> j r I t V <br /> � h'�b i� i r..4 <br /> Date Rece6v�d ,�-3i--(S '! <br /> PhoneCon ctfor.Permittin �'�3 ZE� _�y6S' <br /> Owner's Name �-�►i S G�y�'`���'a Owner Phone Numbeir �S'f3 �s`/� -`'7 sS Y <br /> Owner's�Address �°f'�O i ¢�i2 T �Cl �2-iE3 Owner Phone Numbeir � , <br />, �Fee SimplQ Titleholder Name Owner Phone Number <br /> I <br /> Fee Simple Titleholder Address i _J <br /> JOB ADDFBESS � D�� ��r2���T �� '� /O �Z-2P�YH�f�S FL 3 3�S/Z LOT# Z� � 1 <br /> SUBDIVISION ZePti yc2 �S�-r�s pA CEL ID#�3'2fo`2�' �ti 3d �C���-Op -- 2.1 o q 1 <br /> I (OBTAINED FROM PR�DPERTY TAX NQTICE) <br /> WORK PROP.OSED e NEW iCONSTR B AD /ALT � SIGN Q Q DEMOLISH <br /> INSTiALL RE AIR <br /> PROPOSED USE [�. SFR [_] CO M � OTHER � I <br /> TYPE OF CON3TRUCTION Q BLO�K Q F ME �� STEEL Q , � <br /> DESCRIPTION OF WORK /��P��C J°�w i N�o I/�N B TS i��J '� v(�eN i nJg s ��'i.er �S o�� J <br /> �Llf lSZo�.«-,1/ <br /> BUILDING SIZE SQ FOOTAGE HEIGHT C� <br /> � <br /> �[iUILDING $ 2y��r�� VALUA ION�OF TOTAL CONSTRUCTION <br /> i <br /> [�]ELECTRICAL $ AMP SE VICE Q PROGFtESS�ENERGY CI W.R.E,C. <br /> QPLUMBING $ ;'� ��'i'� ��0�� <br /> �J �,� ��.�,,�-, <br /> QMECHANICAL $ I VALUA ION;OF MECHANICAL INSTALLATION �"� S� �Q <br /> � ,�:�d�-- `�S" <br /> QGAS Q ROOFING Q SP CIALTY '[_] OTHER <br /> FINISHED FLOOR ELEVATIONS FL �OD ZONE AREA QYES NO <br /> � p ,-�i��..�1 <br />' T ` �p �iMf-�G ��'�k.'.�. +�.`_. <br /> iitiittttti � <br /> BUILDER �j�^��-�� � �� COMPANY •l-a+.�-e S _l-�csro�, C e NT'e2� � , <br /> S I G N A T U R E ��" !'-'�v'- I R E G I S T E R E D Y I N F E E i G U R R E� Y/I f <br /> Address o Qo u � �� ��A� �� 3�'��y License# G�oG � J(� ��� �T � <br /> ELECTRICIAN � COMPANY 1 <br /> SIGNATURE I REGISTERED Y/ N FEEE GURRE� Y/N <br /> � �Addr�ss License,# <br /> � _lPLUMBER I COMPANY <br /> SIGNATUF�E I REGISTERED Y/ N FEEi CURRE� Y/N <br /> Addr�ss I License# 1 <br /> MECHANICAL COMPANY J <br /> SIGNATUF�E i REGISTERED Y/ N FEFc CURRE� � Y/N <br /> AddrQSS ' License# I � <br /> i 1 <br /> OTHER � COMPANY 1 <br /> SIGNATURE I REGISTEREp Y/ N FEE's CURRE� Y I N <br /> � Lfcense�# J <br /> Addr�ss I <br /> � � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets�of Bullding Plans;(1)set of Energy Forms;R-O-W Perm(t for inew construction, <br /> `Minimum ten(10)working da�s after submittal dat . Required onsite,Constructlon Plans,�ttormwater Plans w/Silt Fence fnstalled, <br /> - Sanitary�FaclllUes&1 dumpster,Site Work Permit�or su6divisions/laqae projects =---- --`=� -- - --- — <br /> COMMERCIAL_ Attach(3)wmple4e sets of B�ildtng Plans plus a Life Safety Page;(1),set of Energy Forms.R-0=W Permlt for new conshuction. � <br /> Minimum ten(10j workfng daj�s after submittal dat^, Requlred onsite,Construction Plans,�.�toRnwater Plans w/Slit Fence installed, - <br /> Sanitary Facflities&'1 dumpster.Site Work Permit or all new projects.All commerclal requii•ements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '•""PROPERTY SURVEY re�uired for all NEW co structlon, <br /> I <br /> Directlons: � <br /> F(II out application completely, � <br /> Owner&Contractor sign back of applicatior�,notarized <br /> Ii over 52500,a Notice oi Commencement Is required. {A/C pgrades over 57500) <br /> '• Ageni(for the contractor)or Power of Attorrjey(for the owner)wo Id be someone with notarized letter frorri owner authorizing same <br /> OVER THE COUNTER PERMIITING (Fro�t of Application Only) <br /> Reroofs If shingies Sewers Service U�grades A/C Fer�ces(PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public ro dways..needs ROW <br />