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� ' Bullding Department � � ' <br /> Date Recelved <br /> Phone Contact f.o�Permitti� �d�3 � 9 - �('�6 5��,no n�►G�+ <br /> Owne�'s Name Owner Phone Numb r <br /> Owner's Address S� yZ �^� e�� SY Owner Phone Numb r 7�-Z' ZOq- )�08 <br /> Fee Simple Titleholder Name � Owner.Phone Numb r <br /> Fee SI ple TltleholderAddreaa <br /> RESS �1 Y5 TA e'�►ra �R Z-H�NS F(� 33 5�J �.. � LOT# � <br /> SUBDIVI310N �ePE+Q.Y{,�IfS Colo y PARCELID# /2-2fo-2'/-Oo'z8- po�oc� -0000 <br /> (OBTAINED FROM P OPI°RTY TAX NOTIGE) <br /> WORK PROPOSED B NE CONSTR 8 ADD/ALT Q� SIGN [] 'Q DEMOLISH <br /> IIVS ALL REPAIR <br /> PROPOSED USE [� SFR Q COMM [� OTHER <br /> TYPE OF CON3TRUCTION Q E�LO K Q FRAME � STEEL Q ' <br /> DE8CRIPTION OF WORK �, uAL G�/�nlg�auT� o�' q�� Y T N � 5 P�. ��r <br /> BUILDINti SIZE 8Q FOOTAQE�� HEI(3HT 'I <br /> [�BUILDING ($— � ' _ <br /> L__ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE [�] PROO ESS ENERGY Q W.R,E.C, . <br /> OPLUMBINO $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIO `�I v �� <br /> �S�OO� BO <br /> [�GAS �] ROO ING Q SPECIALTY C� OTHER <br /> C7 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA C]YES NO <br /> BUILDER COMPANY <br /> 51GMATURE REGISTERED Y/ N FE CURREA Y/N <br /> Address Licens # <br /> °LECTRICIAN COMPANY <br /> DIGNATURE REGISTERED Y/ N � FE CURRE� � Y/N <br /> Address Licens # <br /> 'LUMBHR COMPANY <br /> lIGNATURE ' REC3ISTERED Y/ N FE CURRE� Y/N <br /> Address �. Llcens # � <br /> � <br /> 1ECHANICAL ��,{ � � /k—� � COMPANY Iz I� �G� Sc.l,a 5� � (�,)� Sp <br /> IGNATURE \I -`��` / � � REOISTERED Y/ N ' FE CURRE� Y/N <br /> Addresa I �Z r�ss�,r� /3(�J T�� F� '33�-�» Licens # �GA�. 18133��'� <br /> �THER COMPANY <br /> IGNATURE REOISTERED � Y/ N FE CURRE� Y/N <br /> Address Llcense# � <br /> � <br /> ESIDENTIAL Attach(2)Plot Plans;,(2)sets o Building Plans;(1)set of Energy Forms;R-O-W Permit for ew consUuction, <br /> Mlnimum ten(10)working days fter submlttai date. Requlred onsite„Constructlon Plans,S ormwater Plans wl Silt Fence Installed, <br /> Senike.ry�Fac!iffles.&1 dum�stgr Site Wo►�c Permit fvr subdl��lsiens/iarge pro)ects __ _ _—______--- _ ___ <br /> OMMERCI�L Attach(3)complete s'ets of Elull ing Plans plus a Life Safety.Page;(1)set of E�tergy Forms. -0-IN Permit for new constructlon. ___ _ _ <br /> Minimum ten(10)working days fter submittal date, Requlred onsite,Constructlon Plans,S ormwater Plans wi Sflt�Fenoe insfalled, <br /> Sanitary Facllitfes 8�1 dumpster Site Wark PerrniQ for all new projects.All commerclal requi m�nts must meeY compllance <br /> 'GN PERiNIT � Attach(2)sets of Engineereci PI ns. <br /> R�f�PROPERTY SURVEY requi d for all NEW consUucdon. <br /> rectlans: <br /> FIII out applicatlon completely. <br /> Owner 8�Contractor sign back of applicatlon,n tarized <br /> If over 52500,a Notice of Commencemerit i required. (A!C upgrades over 37500) <br /> Agent(for the contractor)or Power of Attomey for the owner)would be someone with notarized letter from ov�mer authorizfng same <br /> /ER THE COUNTER PERMITTING ' (Front.o AppllcaUon Only)� <br /> �roofs If shingles Sewers Service Upgr des_A%C Fences(PIot/Survey/Footage) <br /> Driveways-Not over Counter if on public rofid_ ys,,needs RO.W <br /> - , <br />