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- - -- ---- v�cy v� �cEi�tx��tu�� t c�r���tir��}�»t,auv�i �o..-.,�.,-r'v-�.,�� <br /> Building Department i <br /> „__..., <br /> r^n�nti�. � <br /> Date Receiv;d " �j' � Phone Cant�ct,far Permitting �i "3 Z 6'`� -- �''19(ca� � <br /> �.attttnn i�R:L ��s17.��tt � ��• <br /> Owrnar's Name ���Q� ��p� Owner Phon�Mumbe�r �Z�`�N�'S'�3S'� �_�; <br /> Owner's Address� 3��a�' 1.��2{� l-l�m�'c�c/t�� � Owner Phon�tdumbe� �� __� <br /> Fee.ilm��le i'ittehoider Name � ,,,__ � 4wner Phon�t�um6e�^ �� __� <br /> ._..� � _ �� <br /> � _� <br /> Fee:cimE�le't"Ittel�older�iddress � ,_.. <br /> —� <br /> JaB.AD[tRE:3S � 375f?$ GAr�R¢�G. t1am�'+ock dR Ze,�{+�.Y�ilts �t 3 5' I l.CF1"# « _� <br /> (' i <br /> sus��ivcs�ae� ( G1P+(� �un! � P�►RCl�l.O�# �y-Zs=2.t�blo� -�,chcle5cs4 i �t �c*� �� <br /> (OBTAtNED FFiOM P OPERTY TAX NOTfGF) ' <br /> WORK P�OP'OSND NEW.CONSTR AbD/ALT � SIGN � i � DEMQLlShi <br /> e INSTA�I. ��� F2EPAIR } <br /> PROI�OSED IUSE [� SFR [� COMM C� OTHER �' ^ _a <br /> 'fYPE:OF CONSTRUCTI�N [J BLOCK [� FRAM� [,_� STEEL [,� ! � _� <br /> � <br /> DESGRlFFTION OF 1NORG{ �P�AC� I � W i (,��..S�,N�t"S Si TfSi 22. FLI t b8a 3. t � --� <br /> BUILIDlNt�SI�E C� _,� SQ FOOTAGE C�_� HE!{"aNT� I <br /> �w� uum:u� r��a � <br /> [�BU@LD1lVG $ / 7 7 3�Q 3 VALUEITI�?N OF TOTAL CONSTRUCTl4h! i <br /> i�`3 <br /> i <br /> C�ELEcC71�ICAL $ ��� �� �- AMP���RV4CE Q PROG�ESS'ENERGY [� W.R.E.C. <br /> ['��PLIJMB I NC� <br /> ! � ��f�� <br /> � $ ., � � ! <br /> [,r�MECHANiCAL ($ —� VALUf�TIf�N(?F�MECHANICAL INSTAI_L�ITION� <br /> L.. <br /> [_�GA� ` � ROOFING [� SI'El;IAI,TY � OTHER I <br /> FINISHEC)FL+�OR E1.EV�TIONS ��� F(.Ot)C7 ZaNE AREA QYES ' NO <br /> iiit#i-htt�ftft-}tfittftFti-! ft t��1�tfi#�����i�ii�iii-tii#tfii-Ftti i _t <br /> � I <br /> BUlL!)ER La w�s Norne Gz,��zs L4G ;�QMPANY w ��1�� • � _� <br /> SIGN,ATIIRE �eTP.2. ,4NTh,c,��CR�Atza� FtEGISTEREp Y/ N FE�GURRE� Y/N <br /> ��ddress �,��. .�,�('?�31�g ���"N� f"�� Cicensei# CbC 1 S0$�t!"t, _� <br /> ELEC7R{�IAl� {�OIVIPANY _ � _� <br /> SiGN�ATURE �_ REGISTER[D Y/ N Fe CURRE� Y/N <br /> � � <br /> � <br /> � � <br /> �lddeess � �_ �� E.lcensa# ��__ � � � <br /> � <br /> Pl.UMIBEf2 t;OMFANY ,,, <br /> i <br /> ..�.�.._--r_ � <br /> S1GN/'�TURE _ REGISTI=RED Y/ N FEfi GURRE� '� Y I N <br /> � � ..� <br /> �ddress _ � Clcense# �� l <br /> I, MECt�IAN�CAt. GOMPANY � � � <br /> S1GN/�TURE � REGISTrRED Y/ N FEE GURRE� Y/N <br /> � <br /> �hddress � _ � �Ecense# �� �� <br /> 07HER GOMPa4NY � � <br /> S1GNI�,TURE REGISTicRED � Y/ N PEE CURREM1 Y I N <br /> �ddress ^_____� �(cense# �� � i <br /> -tii-Fi-H-4�fii-i-Htti-Fi-H+itf i�h4�fii+Hi�fi-I+fi-Fi- � i+fiiti-Ffttii-ti+fi-1-11-Fi-I I <br /> RESIGEN'TIAt. Attach(2)Plot Pfans;(2)sets of Bu!lding Pfans;(1)sek of Energy Forms;R-O-W Permlt far new constructkon, <br /> MinEmum ten(ZO)working days after submittaf date. Required onsite,Construction Pians,Starmwater Pians wJ Siit Fence lnstalled,' <br /> Sanitaiy Facflitles&1 dumpster;Site Work PermN:for subdivisions/large projects ' <br /> - -CON1hQERCtAL Atiach(3)complete sets of 8uildirtg Pians plus a_t_if�Safety Page;(1�set of En`ergy Fotms.R-t?-W Permft far r�ew constructlon. <br /> i- � ^�` i - `Minlmum ten(10)' or-tn`g=days�afte�su6mitta(=tlate.- Requiied`onsiie,-Gonstruction Plans;-S,o�mwafar=Alans=wl-Si1t Fence-instalied;� -_ ---- - <br /> Sanftaiy Facilities&1 dumpster.Site Work Permik for•all new projects.All commercial requirements must ineet compliance <br /> StGN PEi�MIT Atfiach{2}sets of Englneered Ptans. <br /> *"""PROPERTY SURVEY required for ali NEW canshvokiori. <br /> 17�LUII�1]7��I372 73I ��( <br /> Directfon�: <br /> Fill out application compietely. <br /> Owne:r&Contractor sign back of application,notarized <br /> If ov�r$�5Q0,a�lottce of Commencement is requlred. {AtC up��rades over$7500} <br /> *" Agent(for�the cot7tractor)or Power of Aktorney(for the owner)wuuld be someane with notarized letter from owner authorizing same , <br /> OVER THI?Ct}tlNTElt PrRMITTtNG (Fronf of Applicatlon Only} , <br /> f2erool's if shiniales Sewers � Service Upgrades A/C Fence,s(Plot/SuNey/Footage) <br /> Driveways-Not flver Counter if an public roadways..needs ROW <br />