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<br /> Date Fteae#ve3d
<br /> �=r�f1 Phone Cont�act f�p.r Permlttin � '�� -- t�16� �
<br /> Owne�'s Nan�e �lG��� �5/F'_ Own�3r Phone Number �j3 -�1`�Q'Q�}'2� �
<br /> Own��'s Addfre s� ��-G/L�ll�l,�� !`� Z�����(j�1,� Ownf�r Phone Number � .�
<br /> I �
<br />�. Fee aimple 1'!tl holder Name �,_ � Owna►r Phone�lumk�er � ��
<br /> Fee:ilmpfe 1'Itl ho9der Address � �� r.�
<br /> JOB A,DDRESS ����'Q ��T �y���P�, Z.��P/1/t.�hl I�L 335'_Y 2. ] L07# ��`.�
<br />� BUBIDIVISIOIV �t}�'�+'��zhi�/5 PARCEI.ID#�j���•f_c'�2,�'�.�..9_-C`Y��O� r�QLO ..,r�,�
<br /> {UBTAINED Et20M!PRQAERTY TAX NOTICE}
<br /> WORH:PROi�O$ED NEW CONSTR ADD/ALT C� SIGN [� C� DEMOUSH —
<br /> � lNSTAI_L �� REPAIR
<br /> PROIPbSED U�E Q SFR � COMM �� C�THER [� �__�
<br /> TYPE:OF CON TRIJCTl�N Q BI.00K � Ff2AM� � STEE[. C� � �r.�
<br /> � __._ .._ _ ,.._
<br /> oesc,��pT�a�N OF WOFtK ��AG�_!�_��c�isul�nli?,�' �zx�,.�S.��e FL. lYo�S.Z�+-t 3
<br /> eUILD�ING SIZ �� � :4Q FOOTAGEC� H�IOH7 �� !
<br /> ��� 3:iii��
<br /> [�]BUIL�INC� $ � VAI.UATION q!'70TAL CONS'►'RUGTlON
<br /> 3��z�z�
<br /> [_�ELI: RICAL � W'� AMP BERVICE �� F'ROGRESS ENERC9Y [� W,R,E:.C.
<br />' j�?�l�
<br /> [_�PLU BING $ � �
<br /> [_�MECHANICAI. $ VAL,UATION Qf'MECHANIC�AL INSTALLATION ���v . �
<br /> � y`��..�
<br /> [_�GAS Q ROOFING �� � SPECIAI.TY �] OTH�R � v � � �'/
<br /> FINISFi�D Fl0+R�L�VATtONS FLO{}D ZtyNE AREA QYES NU{'��� �'��
<br /> � �
<br /> ' �t-t-ti-i-tf�f�fi-tit Flil-ttt�#-t�H�i-F! fi-t f-ttfiti-f-Ft�tf-It�lfi-FttFtii�f
<br /> l,tt(/!N�f-Eii't�
<br /> ,/ ,,� �t l 1 �
<br /> BUILIDER ������1 _ . _����� MP'ANY t».0 W�.S ��GlYli,,,''. � T�..(Z, 1.,�
<br /> $}GNA,Tl1F2E �i��, f��T(ftp `f G RA REG(STEREO I�" FEE CURREh Y I N
<br /> ......_,
<br /> �4ddress �t� L3�7� -I`�1 g q 3 �IRN c� M=L 3 Z�7$ Llcense# ��+G t-S o$Y!7 �`.�
<br /> EL�C,1'RIC}AIV w CONlf�ANY C� � �`.�
<br /> SIGFIATURE � REGISTERED �1�I IV fEE CURRE'sM1 Y I N
<br /> ���dress C � ticense# C �
<br /> PLUl�lE3ER COMPANY � _�
<br /> SIGN,ATl1f2E REGISTERED �(I N FEE CURRE� � Y/N . �
<br /> i���dress C_,__ �� r �loense# C _j
<br /> M�GFi�aN1CA!_ • COMPANY � _�
<br /> S1GN,tlTURE C . REGISTERED V/ (� FCE CURRft� Y/IV
<br /> � � �
<br /> E1��dress C� � �tcanse# � �.�
<br /> CJTHEiFt COMPANY C� _�
<br /> S1GN,4TURE C�_ .� REGISTfRED C`I N PEE CIJRRER� Y J N
<br /> E�tid�8S3 C� � LfC9tSSe# C� �
<br /> �Fi+H+ �li-t�F�ti-Fifii-Ft�Hi-I-htfiii-FHi-Fii�ttHfi�Fiii-Mii-F}-Fffi-h}-P+fi�htii-Ff-fi-F�F#tt9
<br /> RESl1)IENTlAI. Attach{2)plot Plans;(2)sets of BuUding Plans;(1)set of Energy Forms;R-t�-W Permit for new co��struction,
<br /> MEnlmum ten(10)woricing days after subrnittai date. Requlred onslfe,Consfructlon Plans,Starmwa#ar Plans w!Silt Fence insta!}ed,
<br /> Sanitary Facllltles&1 dumpster;Site Work Permit for subdivisions/large proJects
<br /> -�"�OMCAEf2C1AL` Attach-{3)ebmplete sets of�Building�Pl�rsplus a-t,lfe-uafety-Pags;{1_}-sejt-of�Ensrgy_Fnrm�.R-{?-W Pecmii_for new_construction.`_ , _�_ F _
<br /> Mlnimum ten(10}work(ng days�after submittal date. Required ons(te,Canstruc#lan Plans,Sformwater Ptans w/;Siit Fence Installed,
<br /> Sanitary Facilitles&1 dumpster.8fte Work F'ermft for all now proJects.All commerclal requirements must meet compllance
<br /> 3tGN P�ERMI7' Attach{2}sets of Englneered Plans.
<br /> `+*"PFtOP�RTY SURVEY requirod for ali NEW canstructian.
<br /> 7TmI3� �12L� ILC� �IIfl
<br /> ?ir�ctl�ans:
<br /> F�ill out aF�p ication completely,
<br /> U4Nner&C ntractar sign baek of appAcation,notarized
<br /> !t`�ver$2500,a Ftotice of Cammencement 1s requlred. (AlC upgrades over 57500�
<br /> " ��clent(fov tCe cc�nkractor)or Power af Attorney(for the owner)would be s�meone wlth notarized letter frorn owner authorizing same
<br /> )VER't'NE C{} NTER PL�RN{17TING {Front of Appllcat3an Only)
<br /> Zeroofs;if shingl s Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage)
<br /> [►rivewa�rs Not over Counker 1f on public roadways„noeds ROW
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