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. . ' �'-----�. ( ; Buiiding Depatiment : .
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<br /> , Date Re�eive,d` , , �— � � ',,�' ' �hone Contact for Permitting � ���•• r- �'�`'��
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<br /> Owner's Name /�/ I � • �wner Phane�Number ,3�1,� zfL�i...f..S��' �
<br /> :�. • ` � wi7l} dfc•..�,n . .. • . ,
<br /> Owner`s Address �.N.S • �• L L� L1�""�e. S� r �vYCter Pttone Nutnbei .
<br /> : .i uye t r C�;?2a� • �
<br /> Fee S3cnple 7itiehalder�1ame I• � ' ` Owner Phone Num6er
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<br /> Fee SicriptaTi�lehalder Addt ss''' f ' • . ' ' ' . -
<br /> • .lOS ADDEtESS ��I� D��Gdrs �!•'II . �.?S�I2 LOT�� :3�' • •
<br /> SUBDIVIStON.� • . . .4a�p,fj 'r�lGIG7��!?�� . •�� • PARCEL ID# �.3 '"�"Z�l����'�~03'''� � ,
<br /> , , � . .(oBFAtNED EROM PftpPERIYTAX NOTIGE}
<br /> WOF2K PROPOSED ' �, :: NEW GONSTR � 'ADDlALT •Q SIGN �[� . MOVE �Q DEMOLtSN. . .
<br /> � tNSTAU..• '•REPAIR
<br /> PROP05Ep USE - Q { SFR . ' , �- COMM Q OThiER ' •
<br /> ' TYPE OF CONSTRUCTiOiV � � BLOCtC �, PRAME ' .C] • STEEL. Q OTHER
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<br /> o�scwPnoN o�woRtc. � �. /� � ar.►�'�.C�� �� . ' „�X i��"/3 . �
<br /> BUILDING 51ZE ' I SQ F007A!C�E�__�,,;_� ' HEIGHT
<br /> ' [�' BWLDING $,, t �VALUATIOf11 OF TUTAL CONSTRUCTI�77N
<br /> . . .z�t .-,1 . . , . . - . , � .
<br /> Q 'ELECTFtICAL �$ ' , �, : ' AMP SERViCE Q PRO�FtESS-ENER�Y - Q 1N.R.E.G.
<br /> ' ' . L.. �� � . . .. � ' .
<br /> .� PLt3N}B1ttitG ` $ � "'--� . ' / / • .
<br /> �} � , . . .. V � .DF ECHAN1CAl.INST�tI.[ATION . r �` .
<br /> MEGHA�2ICAL $ A�.UA"�'tCiR! M s �
<br /> 0 , , , � , . . , ,
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<br /> � � GAS r, � �. R{}OF�N�- ,� . SPECIALTY � `OTFiEE�" ` , .
<br /> FINISHED FLO�R ELEVA ONS � ' . ELOOD ZONE AREA , �YES` ` r0N0 ' '
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<br /> 8t}lLDER �" , ("�� � COMPAHY �trae�/Yt? �C�/�'tGf?��Gi�'�.S .�'/JK.:
<br /> SIGNATURE � � � 11/ � FIEGISTERED � Y N " '�cu�ENr: �Yi!N '
<br /> . Address tS �'/7 s ts.�3'� � •�36 3�/ - ' � . uasnse�.' l�/f'fS2. �
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<br /> E#.E�7'RICIAN.. . • . ' ''`C�ME�ANY ' . . .
<br /> SI!GNATURE tiE�is7�Ren . . .° .Y/ N •���cuttReNr - Y!N '
<br /> Adiiress • ' � ' � �{ � - E.icense# �� ' �
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<br /> PL.UMBEI2 '' _ � ' . `. � '+ "'. , . . CpMPAfi3Y. .. - � '
<br /> SIraNATURE• ' • RecIST�RED Y i N FEE CuRRENT ' Y!N
<br /> _ Address � - . .. • ° �llcenSe#� .�-
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<br /> M�Cl�fANtGA� � ' ' � ' ' ' � COMPANY " � `� . .
<br /> • SI�aNATtIRE • " � �t2EGISi'�RED Y/ �l . FEE GtlREtEN� ' Y!N . . .
<br /> Addreas � � � - - • � ' � , ' _ .iicense# �� �
<br /> � OTHER' . 7( _.;:__. ..__�_...._._.�,.__ ' ._ . . Y • . .
<br /> SI�NA'i'ITRE _._.I_.. i ����zea - "Y! N �ct�iR�' � . ____
<br /> Address � . • . � • ' ' � - . l.icen5e#� .� I
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<br /> RESID�NTIAL Altac�(2)plo Plans;(2)sets of Buiiding Pians;(1)set of�nerg'y Forms;R O�W�Pemtitfor new constructlon,
<br /> . °Mlniii�uurn.ten_ ,0}warking,ciays after suhmittai dake_ Required ansste,Consirucfion Plans.Sf�rmwater Plans wi Sttk Fence installad,
<br /> Sanitary:FaciU es&1,dumps#ei;Site Wotk Perritit for sr�bdivisitins/iarge pro}ea�s•
<br /> �GOMMERCIAL• . ,Attac�►.(3)co plete sets af Building Plans p1US'a Life Safety Page;.(1)set�oF E�tergy Forms.R-O-W 1'.e,rmit for new canstrucUan.
<br /> , �Mlriii��srri fen �10}vuarking days aftersubtnitEa!date. Requirad 4{�slte,Ganstrctction Flans,Stormwater Plans wtSttt FenCe•insfaUsd,
<br /> Sanitary Facit.4ties&1 dumpsEer.Site Work Permit for ail new projects.Aii commerciat cequirernenfs mcfst meet i:ompliance
<br /> �' SIGN PERMIT Aktach(2)sets of Engineered Plans. . _ - � - �" . -
<br /> _ - �"`*P�ROPER� SUI�VEY required it�r all•NE1�1t��anstcuctinn. ' ' - -
<br /> pirectibns: ' . I � � . � .
<br /> �iti out appttca#ton coi�plefely.: • - _ ' • � ,- - -
<br /> OWner&Gontractar�ign b�ick+b�f applicaiiori,notarized ' , , • _
<br /> If�ver�2500,a Notice o#Cotnmencement is required, (A/C upgrades over S500D) ~� '- � " ,
<br /> ** Agent{for the contra�tor)o�P wer o[Attorqey(for fhe awner}wauld be someone wlth notarized letfer irom awner anfharizing same -
<br /> OYER THE GOUNI'ER PERMf?`f I O (Fror�k of Applica8on Only) , '
<br /> .Reraofs 5etn�e�s Servtce Llpgrades AlC Eences{PIo#lSucueylFoatage} . .
<br /> DfIVBways-Not ovef�Counter F on public naadways.:needs RO1N , � - ti r • ,
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<br /> ' . , . aS! . . '��i: ,., , — , ., � • — � .
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