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Bullding Department � <br /> i /a►-. <br /> Date Received <br /> . Phone.Contact f.o�PeRn)tti� g 2(0 6 <br /> Owner's Name N��.L.. �� Owner Phone Numb r $� -� - �O <br /> Owne�'s Address S p � �-O ST Owner Phone Numb r <br /> Fee Simple Tftleholder Name C Owner Phone Numb r <br /> Fee Simple Tltleholder Addreaa C <br /> JOB ADDRE33 / 2D �% Z `y�. � � L �y LOT# � <br /> � <br /> SUBDIVI310N �G�!►� .e ! C� PARCEL ID# J�" —�-I ~�� - � <br /> (OBTAINED FROM P OPNRTY TAX NOTIGE) <br /> WORK PROPOSED NE CONSTR ADD/ALT Q� SIGN [� Q DEMOLISH <br /> e IfVS ALL 8 REPAIR <br /> PROPOSED USE [� SFR Q COMM Q OTHER ' <br /> TYPE OF CON3TRUCTION Q E�LO K Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK ']� p� � �j�� I y M P <br /> BUII.DIN(3 SIZE SQ FOOTAOE C� HEI(3HT <br /> [�BUILDING � � <br /> VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL $ AMP SERVICE Q PROO ESS EN6RGY Q W.R.E.C. <br /> [�PLUMBINO $ �f�� <br /> �� C �� � <br /> MECHANICAL $ ���� UO VALUATION OF MECHANICAL INSTALLATION <br /> DOAS Q ROO ING Q SPECIALTY � OTHER ��3�/ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <br /> � <br /> BUILDER COMPANY ' <br /> 51GNATURE REGISTERED Y 1 N FE CURRE� Y/N <br /> Address Licens # <br /> 3LECTRICIAN COMPANY <br /> 31GNATURE REGISTERED Y/ N � FE CURRE� Y/N <br /> Address � Llcens # � <br /> �LUMBBR , COMPANY <br /> iIGNATURE ' RECiISTERED Y/ N FE CURRE� Y/N <br /> Addresa Llcens # <br /> fECHANICAL COMPANY '!� I� ��S L�C�. S� � (,�� S� <br /> IGNATURE REOISTERED � Y/ N FE cur�Ren Y/N <br /> Add�ess r �• (a•S i S(�/� �1 v J T.�� FG �3 4-II� UCer1S # G��. �g�3�ro`�r <br /> �THER COMPANY <br /> IGNATURE REOISTERED . ' Y/ N FE cuRRen Y/N <br /> Address License# l � <br /> � <br /> ESIDENTIAL Attach(2)Plot Plans;(2)sets o Buliding Plans;(1)set of Energy Forms;R-O-W Permit for ew construction, _ _ _ <br /> Mlnimum ten(10)working days fter submittal date. Requlred onsite,;Constructlon Plans,S ormwate�Plan§wl Sfit Fence In§tailed, - <br /> Sanitary:FaclllUes 8 1 dumpster Site Work Permlt for subdivlsionsAarge proJects <br /> �6M�iERCiAL---'A4tach(3)-compiete�setsaf�lull �ng Plans plus a L-i�e S�faty Page;(1�sat�fEnergy Fo�ms. R-�=Vd f'emiit for new constr�ctlon. -- <br /> Mlnimum ten(10)woricing d�ys fter submittal date. Requlred onsite,.Construction Plans,S ormwater Plans w/Sllt Fence installed, <br /> Sanitary Facilities 81 dumpster Slte Work Permit for all new pro)ects.All commercial requi ments must meeC compllance <br /> 'GN PERMIT Attach(2)sets of Eng'Ineered PI ns. <br /> ""PROPERTY SURVEY requi d for all NEW constructlon. <br /> rectlons: <br /> FIII out appllcat(on completely. <br /> Owner 8 Contractor sign back of application,n tartzed <br /> if over 52500,a Notice of Commencemerit f required. (A/C upgrades over 57500) <br /> Agent(for the contractor)or Power of Attomey for the owner)would be someone with notarized letter from o�nmer authorizing same <br /> /ER THE COUNTER PERMITTING (Front o AppllcaUon Oraly) <br /> :roofs If shfngles Sewers Service Upgr des A/C �ences(Plot/Survey/Footage) <br /> priveways-Not over Counter if on public roF�d ys..needs RO.W <br />