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vwlunla vvNa��nram <br /> )ate Recelved . �'' Phone.¢ontact fpr Permittin S ti 3 �C -�7'�S n^o��'�� <br /> >wner�s Nam'e �Rfl Sm�''T h Owner Phone Numbe 1�, "�`l�-`i 31 O ., <br /> h�vner's Address 3 8 �Z S GA^"denl ���. ; Owner Phone Numbe <br /> �ee simple Tltleholder Name Owner Phone Numbe <br /> �ee 3lmple TltleholderAddreaa <br /> iOBADDRE33 38625 �,,n�e� A,r,� �phayh�►ls r� 33SYo LOT# � � � <br /> tUBDiVi310N i PhA i IIA y� C STATis PARCEL ID# ��'2 S-Z� -UO A-OOOOD �- /�o� <br /> ' (OBTAINEb�FROM PR PERTY TAX NOTIGE) <br /> YORK PROPOSED e NEW CONSTR 8 ADD/ALT � SION Q Q DEMOLISH <br /> INSTALL REPAIR <br /> �ROP08ED U8E Q SFR Q COMM � OTHER <br /> YPE OF CON3TRUCTION Q BLOCK �] FRAME C� STEEL Q <br />'- 1ESCRIPTIONOFWORK F��AC2 i U iTS �nl 7 ��N!!V S�� SiZ.e.F�-I 83�f. <br /> IUILDINO SIZE SQ FOOTAOEr_� HEI(3HT FL I 18Z8.Z <br /> ILDINO $ 2�I� �.7 VALUAtION OF TOTAL CONSTRUCTION <br /> i <br /> DELECTRICAL $ �AMP SERVICE PROO ESS ENERGY W.R.E.C. <br /> r� a <br /> QPLUMBINO $ i oO� <br /> �]MECHANICAL $ �VALUATION OF MECHANICAL INSTALLATION `��� <br /> QGAS �] ROOFINC3 Q SPECIALTY [� OTHER <br /> INISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br />� G ��� j,�l_' <br /> � �7,�,D� <br /> ;UILDER OMPANY �Ow-2S l�oM�, CeN'��2s� ' �/�- <br /> IGNATURE � REGISTERED Y/ N �E CURRE� Y/N <br /> Address � QO u � ��J 2�A���" 3�-��� Llcens ��o S() 1 <br /> LECTRICIAN ' COMPANY <br /> IGNATURE REOISTERED Y/ N FE CURRE� Y/N <br /> Address Licens <br /> LUMBER ' COMPANY <br /> IGNATURE ; REOISTERED Y/ N FE CURRE� Y/N ' <br /> Addresa Ucens <br /> ECHANICAL COMPANY I <br /> IGNATURE RECiISTERED Y/ N FE CURRE� Y/N ' <br /> Addresa Llcens <br /> THER COMPANY <br /> IGNATURE REOISTEREQ Y/ N FE CURRE� Y/N <br /> Address Licena <br /> ESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for w consUuctlon, � <br /> � Minlmutn ten(10)working days after submittal date. Requlred onsite,ConstrucUon Plans, rmwater Plans w/Sllt Fence Installed, <br /> Sanitary.Facllides 8 1 dumpster;Site Work Permit;for subdivlslonsAarge proJects <br /> 'OtYIMERCIAL Attach(3)complete sets of Bufiding Plans plus a Life Safety Page;(1)set of Energy Forms. -O-W Permit for new construction, <br /> � Mlnimum ten(10)working days after submittal date. Requlred onsite,Construc8on Plans, t rmwater Plans w/Silt Fence Installed, _ <br /> Sanitary Faclllties&1 dumpster.Site Work Permit�for all new proJects,All commerclal-requi ments must meet compliance � <br /> !GN PERMI7 Attach(2)sets of Englneered Piana. � <br /> "`•PROPERTY SURVEY requlred for all NEW construcdon. <br /> irectlons: <br /> FIII out appllcation completely. <br /> Owner&Contractor sfgn back of application, notarized <br /> If over;2500,a Notice ot Commencement Is requlred. (AIC upgrades over 57500) <br /> Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth notarized letter fro wner authorizing same <br /> VER THE COUNTER PERMII"TIN(3 (Front of Application Only) <br /> aroofs If shingles Sewers Serolce Upgrades A/C Fences(PIoUSurveylFootage) <br /> Drlveways-Not over Caunter if on public roadways..needs ROW <br />