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� vut���+i�VvY4�at��V��4 <br /> mc»iGA <br /> p�=���df � Pho�Cont�rrrnact f�or Permittin '$� Z�o ��t0`j � <br /> i t� �� � <br /> Qwner'g Name( Mf��rl2l.t� �`1�A�r�/ Own�3r Phone Number � ` tf��^ qy�� <br /> OwneR's Ad�ir�ss�Vr �.� fK.�d/� ��l � Own��r Phone Number C �� <br /> Fee:iimple 1'itlehotder Name ��� �� Owne►r Phone Number � �.� <br /> � T �.J <br /> Fee;'simple 1'if eholde�Address �� .� .r � <br /> � �.. h �'" r� ��f� <br /> JQB 1�DDRESS �(o `� R o N�� � _�'�,�hRy h i t t5� �3 3 �a�r� �.�� <br /> su�b�visiaiv rsun75e.T �5TA'r�_�� PARCEL ID# I�•-26-21-03!O-C�C? - O`71 O �.� <br /> (U9TAINED FIZOM I}ROPERI'Y TAX NOTICE) <br /> WORM PROF��SED NEW C()NSTR ADD/ALT [�,� SIGN �� C! DEMOLISN <br /> tNSTALL � REPAIR <br /> PRa�PoSED tiSE [� SFR �� COMM [� CTNER [� ���] <br /> TYPE:OF CON�8TR1JCTt�N � BLOGk � FRAMr � STEEL � C ��.] <br /> DESt,IRlPTtQ�N OF 1tUdRit [��:1ll.r?l��"L�_...�� f"���I.����"'�'1JG'e,,. /..I��,_„�.��ES� <br /> BUlL[11NG 51Zi� �� � :3Q F007AGE�� NEIGttT C , <br /> �F�� � � <br /> [�]BUI�DINC3 � •�� VA[.UATiON O!=TOTAL C�NS'fRUCTIC3N <br /> [_�ELI=CTRICAL ($ ��� AMI'SERVlCE �� F'ROGRESS ENER{iY [� W.R.E.C. <br /> � <br /> [_�PLIJ BING $ �� <br /> [r�MEC ANICAL $ VAL.UATlQN Of'MECHANIC:AL INSTALLATlON � <br /> � �� <br /> [_�GAS [� ROOFING �� SPECIALTY [� OTHER \" <br /> FINIShIEQ FLOOR ELEVATIONS C� �} Fl,QOD ZCtNE AREA �YES Nt7 <br /> � <br /> i-ti-Ff•h9-Ff-Fitt Ff-Fi�f� ttH-Ff�41-fi-ti-lii-Fi�t�Ht1-Fiiii�t�hftti+ti-f�tth t-ti-hti�-}-FtfhH-ti-Fthtf!-tl�1 <br /> BUILIDER �..� GAMP'ANY C.�O W�e.$� i-�ome T'�-2,.. L.� ��.] <br /> SIGNA,7'URE ���e. ,!q_t�STFtipl�"� G RO REGISTEREQ �Y/ M ` FEE CURREt� Y J N ' <br /> �� <br /> �Address �Po t3o x "7819 4 3 O R�AN ca rL 3 2875 Llcense# G�G �.��Sy/7' �.] <br /> E�EG1'RtC1AIY COMWANY C � �.� <br /> SlGNATURE REGISTERED �Y/ N fE�CURREh Y/N <br /> 1��ddress C ___� License# �� � <br /> PL.UNIE3ER COMpANY C� T�� <br /> SIGfJ,ATURE REGtSTEREd �(I N FEE CURRE�� Y J N <br /> i���dress [� �� Llcense# �� �, <br /> MECHr4NtCA1_ ` COMPANY <br /> SlGN,ATURE � REGISTEftEO � l�I N F[E CtlRREP Y!N � �� <br /> �� �..�_� <br /> il�idress [� �� License# C,,,` �.� <br /> DTFtEiFt COMPANY C� �] <br /> 51GN,ATURE ��GisteR�o �C'/ N Fe�cuRRen � Y i N <br /> 1\ddress C� ] l.fcense# �� ��� � <br /> �f-ti-t-t-t+ttttilFtfi�tti -FHii-�tf-ft�0i-ti-ftti-httrfifi�f-}f-Fi+F�ti+Hiii-tfi-Ft+tii•lif+i-Fiiiiitt-FFf#t fi�P-hti�9 <br /> 4ESII3lENTIAt. Attac�{2)Piot Pians;{2)sets of Bullding Plans;{1)sat of Energy Forms;R-��-W Permif far new Construction, <br /> Minimum ken(10�working days��ter submittai date. Requlred onslte,Canstructlon Plans,Stormwater Pians wt Silt Fence Installed, <br /> Sanitary Facllltles&1 dumpster;Site Work Permit for subdivlsions/large proJects <br /> --.,.OM�MERCIA�. _ Attach{3}_compiete sets of Build(ng Plans plus a Life Safety Page;(1}sFt of Energy Porms.R=0-W Permlt for new cbnstructlon: - � <br /> Nlinimum ten{10)working days�fter ss�bmftta!date. Required onsfte,ConsEructlon Plans,Starmwater P1ans wl•Sllt Fence insta{ted, <br /> Sanitary�acflitles&1 dumpster.Stte Work F'srmit fnr all naw proJects.All commercla!requfrements must meet campllance <br /> i1GM1i P�ERMI7' A#tach(2)sets of Englneered Pi�ans. <br /> """PF20PERTY SURUEY requlred for aN NEW aonstructlon. <br /> �2��SII � �L� <br /> 3iroci:i��ns, <br /> F all out app�icatlpn compietely. <br /> ; C)wner&C�ontraotor s(gn 6ack of appticatlort,nntarized <br /> N`�over$:�500,a Notice of Commencement Is requlred. {AIC upgrades over S750Q� <br /> ' F�c�ent(for lhe cnntractor)or Power of Attorney(for tha owner)would be sUmeone wlth notaeized letter from awner authorizing same <br /> )VER'[HE Cf)��NTER P�iRMlTTINC3 (Frant ot'App!lcatlon Only} <br /> reroofs,if shing��es S�wers Servlce Upgr,�des A/C Fences(PIoUSurveylFootage) <br /> E�riveways-Not over Counfer If on pub(�c roadways..nosds 120W <br />