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. •. . Bullding Department <br /> Date Recetved -�f�..� �hons�a�tact for�e�m:tt�ng 1� +� � - f� t� <br /> OHmer's Naane /! � S C.+f� `��i'1"�'e Owner Phaae Number ��= f 1 ^ Gff} ��` <br /> �,/ �„.S�.7�! <br /> Owner'sAddress /�. � c.'.t' �! � ��� n r , �wnerPhone Num6er <br /> Fee Slmpl�i'itlehottler Name �� � � �+nrrser P6one Number, <br /> Fes Slmpte tiElehotder Address <br /> JCJB ADQRESS SC� 'Z' i^' �� S � L.. ����'0 l�OT# � <br /> SUBDMSION �� PARCEI.I�# <br /> (08TAtNED FROM PROP&RTYTAXNOTICE} <br /> WdRK PRdPOSED _ niErN CON57R ADD/ALT � SIGN (� � Q DEMOLiSH <br /> e CNSTALt. �` F2EFAiR <br /> PROPOSED U5E Q SFFt Q •COMM � OTHER <br /> TYPE,OF Ct7PtSTRt1CTtOtd Q BLOCK - Q FRAME Q 5'i'EEL Q �� <br /> ' DESGRlP71Qld OE WOEt14 . e :.12 • - `'.p �'' �' �f`-' �-/d � !`�'' <br /> - ���""'c..�-� <br /> ' BUIL�IIWG 51ZE � �. SG�FOOTAGE � .S�'a H�IGHT � <br /> � - <br /> k �BUILDtNG 5�j� � VALUATtON'OF TOTAL CONSTRUCTI4N <br /> C1 <br /> � QELECTRtCAL ��� AMP SERViCE Q PROGRESS Ei�1EFtGY Q W.R.E:C. <br /> C]PCl3MBING $ !y�� r �� <br /> I �C <br /> , �- �� <br /> OMECHAN�CA� � VA�tlA�tai+t 4F MEGHANlGA!lNSTALCAS�dN. <br /> ' � ���G <br /> ��as 0 .�Qo��r�G � sgEci�.�r 0 o��E� <br /> FiN(SNED:FLOOR ECEVA7iOhiS ' FLt�OD ZONE AREA QYES NO � �J��� �'"' <br /> ✓ <br /> � _ t <br /> j.� ���" , .� � '� a �,.t� <br /> BUtCDER y�•" ,!jA;/i� � � COMPAn1Y � .�"t.�'► r�h�t,f"�i��iC <br /> StGfilATURE ' - � ,?lt ..��:r� l�- ���ss� zX�!.iv F�e cuR�n Y/N <br /> Address 1 License.# �—i � <br /> ��- � � r �,...�....�.--- <br /> E1.EC't'6ttC1 � , i�� COMP7aNY" C..�I �'�!T��-�o�� j �/�T+j�- <br /> SIGl�lA7't! s�GtS7Ect� Y/ N' �Cu�R� Y!N <br /> ���:�� �, 1�7� a �w ��, ���1�- �Ci�����1 <br /> ', s�+ aaress _ �, ucense# <br /> i .� L, - - - �-,_.,.� <br /> PLUM�ER ��t COMPANY <br /> SIG4yATURE REGIST6RED Y J N �E.E cu�tEA Y 1 H <br /> Adilress �1 Llcense# �� � <br /> _„ .:.. V`' <br /> MECHAt�iiCAL ��} COMPAI�Y <br /> 51�NATURE �rs�o Y 1 N ��cuRRsn Y 1 N <br /> l�ddress license# �— � <br /> �BTHEi2 � COMPANY <br /> SlGNATURE REGISrEREo Y t {�) FEE CtSRREK Y,!td <br /> � Address llcense# ! �� <br /> R�SIDEF!'t1AL Attach.{2)�Ptot Ptans;(2}sets�of 8uild'ing�Pians;(1)set af Energy Porms;R-0 V11 Rermit for new construction, <br /> N{inimnm ten{10}woric�ng:ifays-after.suDrnlital tfate. Requi�ed onsite,.Conslruction P1ans,.Starmwater Ptans w/Sitt Fence instatted, <br /> Sanitary Facll(tles.&1:�dumpster,'Slte Waric Permit for.subdivisionsflarge proJects"'�'•;""""' <br /> COMRfIERCiAt AtFach(2)coritpieta sets of Buitding_Pians plus a l.ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructfon. <br /> Min�rrtum ten{10}worktng tlays after submiftat date. Required onsite,:Gsnstrvct�on Pians,Starmwater F'lans wPSilt Fence instailed, <br /> Sanitary�actlities&1 dumpster.Sike�War#c Perrr�it for alt new proyects.Alt commercia!requirements must zneet compliance <br /> SiGN PERMI'i' Attach(2)sets of EngfneerQd Plans. <br /> •"•PROPERTY SUF2VEY'repuired for.alt.NEW eonstre�ction. <br /> � Direct➢ons:. � � � � � � <br /> � Fif aut a}ipiiCaBon completeiy. <br /> Owner&Contractor sign back of appticatfon,natarized <br /> If ov�r$'`2500.a Natice of Commencement•is requfr�d. (AIC upgrades over$7800) <br /> " Agent(far the contractor)oc Power of Attomey(ffir Uie awner)would be someone with notarized fetter from owner authorizing same <br /> Q1lER THIE CCIUNTER FE[t1Ull7l'iNG .(copy of contradt'required) <br /> Reroofs if shingtes .Sewers Serviae Upgrades AtC - Fences{PIot/SurveyiFobtage) <br /> DN�ewaiys-Not over Counter if on public roadNrays..needs ROW <br /> . - � - <br /> It _—.---- --------- ___-- - <br /> � _ - -.- <br /> — <br />