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+ Bullding Department <br /> t�'1Qnri t(I <br /> �� <br /> Date Received phone..C,o,ntact f.or Permittin , "l'3 2�'� -- �`c'16 <br /> Owner's Name +��-���A c?7�+ I o Owne phone Number ��3 -� <br /> Owner's Address Q4j I �2NN�d /aU� Owne Phone Number C �� <br /> Fee Sim le Titlehalder Name . Owne�Phane Number �� �� <br /> p I� � � <br /> Fee Simple Titleholder Address �� <br /> JOB ADDRESS J �21�1A1 1� !1i II$ j. 33SYz � l.OT# ����� <br /> � <br /> suao�v�s�a� �-1`ntColn! fler'q�7�S � PARCEI.(D# /2-2FL-2 -c�?.�"o-Odoo � t�Y7Q �� <br /> (O ITAINED FROM PRQPERTY TAX NOTICE) ' <br /> {MORK PROPQSED NEW CONST4t ADDtALT � SIUN Q Q DEMOLISE� <br /> e iNSTA�L 8 REPAIR � ' <br /> PROPOSED U5E Q SFR C] GOMM �� O�'HER , _� <br /> TYPE OF CONSTRUCTION [� BLOCK Q FRAME �� S �EEL Q �- � <br /> DESCRIPTION OF WQRIC �nt 22�' ��' �`/�r' /� � i L;�t,� �,rP r.�.��'� 1 - !o'�,ar� <br /> BUIL.DING SIZE � � SQ FOCti'AGE�� H�_lG1�IT �� <br /> a:� <br /> $���'QE�C' � �/t^ys,ey ,�,,�� VALUATI4N OF TO�'AL COt�S RLlCT4C}N <br /> =C;�v.vw <br /> �El.EGTF2ICAL $ � AMP SERVECE � PFt4GF2ESS ENERGY Q VV.R.E.C. <br /> �P�UMBiNG $ � <br /> �. � � �} � � <br /> �MECHANIGAL $ VALUATlON OF MECHANlCAL NSTALtATlQN ` � <br /> OGAS ' Q f200FlNG [� SPECIALTY � O HER <br /> FINISHED F1.00R ELEVATIONS FLOOD ZONE AREA QYES NO <br /> � � �tt�iti-t�ht <br /> BUILDER �COMP�N,��M --LO 2 I�OtY3 _ C2NT 5_ LCty,`,a -� <br /> SIGNATURE REG�sr���p -Y/ N FEE CURRE� '- � Y/�N /� <br /> Address o 7 '�R 3 F�- Z,S S � l.icense# i C�,G 15"�}$�I`"1? �� <br /> _._...�._._-�- <br /> ELEGTRIGfAN COMPANY M� <br /> SIGNATURE R6GISTERED , / N FEE GURRE� Y/N <br /> Address � License# � ��� <br /> PLUMBER GCDMPANY �� <br /> SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � �� <br /> MECHANICAL COINPANY _� <br /> SIGNATURE REGISTEREp /` N FEE CURRE� Y/N <br /> Address � License# �— �� <br /> OTHER COMPANY �� <br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N <br /> Address l.icense# �+ �� <br /> iiiiii+tt <br /> ftESIDENTEA� At#ach(2}P1at P'lans;(2}sets of Building Plar�s;`(1)set of Energy Forms;Ft -W Permif for new construction, <br /> Minimum ten(10)working days afker submittal date. Requfred onsite,Construc8on Plans,Stormwater Plans w!Silt Fence(nstalled, , <br /> Sanitary FacillUes 8 1 dumpster;S1te Work Permit for subdivisionsAarge pr�Jects _ <br /> ;�COiVFMERCiAI.—Atfacfi�(3}ca�ete sets of"6uild3ng Plans prs a Clfe Sa�#y!'age;{'f}set of Energy Forms.i2-0-1N Permlf for new canstri.rct(on. <br /> Minimum ken(10)working days after submittal date, Required onsfte,Cons;truation Plans,Starmwater Plans w/Silt Fence Installed,. <br /> Sanitary Facilities&1 dumpster.Site Wark Permit for a!1 new proJects.All a�mmercla!requlrements must meet compllancE� <br /> SiGN pERMtT Attach{2}sets af Engineerecf Plans. � <br /> """^PROPERTY SURVEY required for all NE1N.construction. <br /> �.I3 <br /> Directians: . , , _, , <br /> Fill out applicatian completely: �' " - � ' �" <br /> Owner&Contrac#or sign bacic'of application,natar�zed "' • , ' <br /> if over 52500,a Not(ce of Commencement ts required. (A!C upgrades aver 57500) . � . . , � � <br /> "' Agenk(far the contractor)or Power of Attomey(for the owner}wauld be someo�e with not rized let#er from owner authorizing same <br /> > <br /> OVER 7HE COUNTER PERMITTING (Front of Application dnly)� � <br /> Reroofs Ii shingles � Sewers Servlce Upgrades A1C �Fences(PIoUSurvey/Faotage) <br /> Driveways-Not over Counter if an public roadways..needs RQW <br /> Y � <br />