|
-�� ,�� ���-� ��ry or Gspnyrnnis r�ermit�+ppitc�Tic�n r'ax•ti��•�uu•uu�;i
<br /> BuAding Depar#ment � �
<br /> ' ._.__.....�.�. �....,�� _, � s
<br /> Date�teceived ' �������, � � ��
<br /> � � '�'hor�e Cont�sct f.ar Pertnitting f �,�-RR�o m�o�,,� a�
<br /> 1�t
<br /> Owner's Name L Y 6�'�-Owner�Phone Number ��(3',�/2�y�� �
<br /> � , �
<br /> �
<br /> Owner's Address�� 4 ,,�, QwneriPhon�Number [ ; _���
<br /> Fee 8lmple Titlehold�r Name C��U`�C ,�?�j ��� pwner.Phone Numbar C� ; ^���
<br /> �
<br /> �� � :_..s.___
<br /> Fee 5lmple Tftlehald�r Add�ess �i'� I
<br /> , ,
<br /> JOB/ADDRESS ����iA I l �1 UC� G'�h�Yh;/f�5 �C �3,z�� � �.aT# 'C�+g.��
<br /> �__.. TM �...��, I �,�___•
<br /> SUBDi111S10N ��,�� ,2 ' .5 PARCEI.iD# i Z�-�.1 -OG�/�S - 2c�D -pc�1��� _._._.��
<br /> ' (OB,TAlNIcD FROM PROPLRTY TAX NOTlGE} �
<br /> WOR44:RROPOuED �� NEW CONSTR� . ADDIA�T �� � 51�N C� "[� DEM01_ISH
<br /> INSTAI.L REPAIR i
<br /> FRQPUSED USE. [� SFR � GOMiv1 • � OTI-IER [ _ ' �,_��
<br /> TYP�OF CONSTRUCTION C] BLOCK C] FRAME � STEEL [� [--�� _�_��]
<br /> DESCRIPTION UFWORK C��C Gl1G,)AIA(� �4d�D-F I�.�L ��j,J ]''�Q �'"�(pDL PAC��i UNI� �
<br /> ��... �,.r- ---�� i-�� �.._._...._
<br /> eUILDING SIZE C ` ^� SQ FOOTAGE�____� HEIGHI' ��_� �
<br /> �G�� �:Fusrra
<br /> �BUILD(NG I$ � VAI.UATION OF TOTAL CQNSTRUC710N i
<br /> �
<br />� �E1.ECTR(CAC. $ � AMP SERVIGE � PROOFtEuS E:NERGY ; W.R.E.C.
<br /> I
<br /> C�Pt�UM81N(3 , $ .. ^� ..
<br /> i �NiECHANICAG $ ' VAI.ItATI{)N OF iv1ECHANICAL 1NST�t�lr4T10N � �--"-'
<br /> ��'�� �
<br /> �c�As C� �ao��r�� � sPEc�A�TY�(� o�'H�� :: -ti;
<br /> �
<br /> , F.INISMED FLOOR ELEcVATI(JNS � � FLOpp ZONE AREA, ��YES NO �
<br /> � ttt-H•11�H�htti�tittttil�tthf-t-H'ftfttH tH�t-F�Htifitti�i-tfiH-lltti�tt-FiitHittttttti-Fi-H-Ht�f-Fi-ftM
<br /> BUILpER � CqMPANY ���� i �„^.�,�
<br /> SIGNA7UR� " �� REGISTEREp Y/ fJ�' � FEE CURRE� Y!N �
<br /> ,
<br /> i
<br /> �Address � �� ^�. l.lcense# C '� �,���
<br /> �
<br /> ELEC?'RICIAN � COMPANY � ^ "���
<br /> SIGNATURE ' RBGISTEREQ � Y/ N � FEE CURRE� Y/N ~
<br /> � Address ���� � l.icense# C ! !„� µ�
<br /> � —___.r _ i _____—
<br /> PLUMqER COMPANY C� � _,���
<br /> SIGN�ITURE _� ' REGISTEREp Y/ N � FEE CURRE� Y/N
<br /> Address C ,_� � L.icense# ��, i �,,,,�,��
<br /> MECHI�NiCAL � CQMPANY ���,9� r��G' `.�'c.U�.!S��! �-. ��S�..:�,��
<br /> , SIGNATURE �� REGISTERED Y/ N � FEE CURRE� Y/N �
<br /> Address ���fl'1t�.S"S/�.�/''�ca (3(u�17;'�.,ti�+�,. (-'�. `�3��"t L.Icense# I�A� ����.5' �i�~
<br /> OTHEF2 � COMPANY � ' � _,�,_�,�
<br /> SIGNATURE „_� R�aisrea�a Y/ N _]- FEE CUftRE� Y/N
<br /> f i-
<br /> Address � �� ___ l,icense# �_, ,,,_,_,,�
<br /> fiii-fi-ttttttttt•Fti#tM-htH�t�ti'tttittt#-ttttt�t� l�ttt�Fh!-Hiittttt�tttt- ttfi-t�HH•ttf�ii
<br /> RESiDHNTiAi» Rttach(2}P(ot Plans;(2)sets of Bu11d1ng P1ans;(1}set of Energy Forms;R-O-W Perrnit for new construcfion,
<br /> Mlnimum len(10)working days after submlttal date, Required onsite,Constructlon Plens, Stormwater Plans w/Sili�Fence installed,
<br /> Sanitary:Facllltles&'S dumpster;Slte Work Perm(t(or subdlvlslonsilarge groaects �
<br /> COMMERCIAL Attach(3)complete sets af Bullding Plans plus 1 Life Safety P�ge;(1)set of E:nergy f�orms,R-O-W Permit for new con�;tn.rction.
<br /> Minimum fen(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/SIItiFence instailed,
<br /> S�nitary Faclllfles&1 dumpster.S1ts Work Parmlf fvr a31 new pra�ecfs,A!1 commerclal rsqulrements must meet'comipliai}c�a
<br /> SIGN PERMIT Attach(2)sets of Engineored Plans, ,
<br /> """PROP4cRTY 3URVEY required for all NEW constructlon. �
<br /> :�TU��FmzL� zI�t�tL��SC � tLIT�t:I�t�
<br /> Dlreatlons: �
<br /> Fil!out appllcation completely j
<br /> Owner&Cvntracfc�t slgn back af appllcatian,natarized �
<br /> If over$2500,a Notice��f Commencement is requlred. (A/C upgrades over$7500) �
<br /> "* Ac�or�t{for the ca�tractor)ar�ower of Attomey(for the avrner}would be someone wlfh notarized letter from owner authorizing sam;e
<br /> OVER THE COUNTER PERNIITTING (Front af Application Only)
<br /> Reroafs ff shingles Sewers Service Upgrades PJG F'ences{PIoUSurvsylFootage) �
<br /> Drfveways-Not aver Counter If on public roadways„needs ROW ' �
<br /> �
<br /> �� _ �
<br />
|