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t�uiFa�ng Uepartinent
<br /> ! _ YYZI� ;.t i�._._(,r.._.._._
<br /> Date Fteceiv�idl � y ���,��.-�� �Phane ContaeC far Permi#ting� „Z(o --
<br /> 2i:tlixm'Smxm :m�1: rrrrmti ]x �Tgx�� 1� �
<br /> Own�e�'s Name� ,.i���' L.�.�,t��� ._.. � Owner Phone ESumber � �
<br /> - __—...�..., �. .�.:�R — r 2��.____.
<br /> Own�U's Adc�rias��[ ����Q�j G'f�j ���� �� Ovyner Phona Number C � ��.�
<br /> Fee lilmpie 1'ltiet�otder�1ame C _^_�� �� �7wner phone Numk�er C �� ^ �.�
<br /> Fee l�fmple'Yitlettolder t�,ddress C� �_�^ ^ `_�_^r�. ��_ ���
<br /> .�og�,oQe��:s:� � �_��{��G�'h ��e.. Ze.�h l�i L�...��3�.'S�2 � �.o�r# � !:3 �.� �
<br /> ' - .--.— �—' _� _._i �.�.` �_
<br /> SUBIpIVISIOIV � ��ynJsc��,j�5"T/�j��?� PARC�L(D#C.`�.�'•�-�-2! -�`��.� ._�i�?C�,—i��3C�,�
<br /> ! (087AINE:p l�l20M l�ROPERTY TAX N�71GlS)
<br /> WORN�PRO��C�5E:D� � [� N��E�C�C')NS1'R�� REPAIR C"� SlGN (,� C� DEMOLISN
<br /> C
<br /> PF2o1POSED U;�E ' C� SFR i� COMM C_.� ��THER �-- ��, _..._�.�
<br /> TYPE:OF C:�ON�STRt,flCT1�+N �� BLOCH: �� FRAMr �� STEEL �_� C�� �_�.�
<br /> F?ES{:IRIPTlCbN 01=U�JORis;� .�t`�,j"�"R I,� �'2,,,''�j �� ��j����_�Q7�ICC� .�3a���..��_,.�
<br /> i I
<br /> BUlLI�ING SIZfc i M_,�____ � s5t�l-00TA�E��� Fi�iGHT' [�� i
<br /> :u�:u�rzua�ztut��azGr�r.r�sl:r-��xu�aas.tu�ct�xut�r�tz�ra�u�ua�s�tz���taz�t�uuiz��
<br /> [�E�UILI�INC:� . ~ VALUATION Oi=TOTAI.CONSTRUC'T'iON
<br /> � �.�3�.���
<br /> [��E:LIrC:TFtIi;Al. $(�'� —r� �1MN SERVICE � F'ROCRESS ENE#2t�Y �] W,R,E:.C,
<br /> L,
<br /> L_�FLUMBINC3' ($ �� `�� ��r-a/
<br /> � �� (O
<br /> [.��MECNANI(,AL $ `�� VALUATION Of'MECHANICAL lNSTALfJ�TlON .�
<br /> �
<br /> i
<br /> [::�cas C� ROOFING [� SP�ClALTY C,_] OTHER
<br /> ;
<br /> 1=1NISHED FLOUR E:LEVA'I'IONS �—� FLQOCJ ZC)NE AFtEA C�YES NO
<br /> itt-Ft-t�fi-tttfftfiFf-ttt�-tti�t-�tttti-Mht'tiil-Fti-h lthi-Ftf'ti�i-F�FN`fi�i-hHti�f-H�f-httttfi•ht-Ffifi-h9-I-tttf-t-ttfi H�tt•Hii-t�l-t-H-ti-tttttttfi-hi-t•t�l�!•}i-Ithl-tfFl-!t�{
<br /> �
<br /> E3UlLiC)ER � �� Ct)MP'ANY �L a w�.s �"tdMQ. �F' T�2���., �]
<br /> :iIGNA,TUR6_ _�'�?�Jj"� �'�p/Jt ��;�2,�� REGISTERED Y/ N FFE CURREt� � _..
<br /> 2 f� � ,_.._._ ^ -��1" � Y/��..5_
<br /> �Addre:�s �_i:?fO ��p 7ty,_,��I qi�$� �)(L�Ar�. c� NC. "3 Z8'y�� L.Icen;;e# «�L l.SO���/I 7 � _..�
<br /> � _
<br /> E:l.EG1'RtClAIV ' � i� C()MWAIVY C —.1�. '-'"' _...,
<br /> EiIGN.FI.TU�l'I� __ ^ ftEGISTEREd Y I �«T� FEH CURREt�� Y/�� �
<br /> t4�idrass �-- � .,__� .,`._� `� Licensa# �� ,., �.�.1
<br /> F'LtlHIE3ER -- ' ------ ---- — CCIMPANY �_ �_� � �.._._..J
<br /> y�������'f� __ ��„_ „__,_ REGtSTEREO Y J N � Ft_E CURftEh� Y 1�
<br /> l���dress �--y�.__y� �_Y_ � Llcenso# C� _�.1
<br /> 41ECN�ANiCPt1_ ----.._ .—. _ .._�_ C�MPANY [� —._—.Y.�.� ...�. _....—.�
<br /> 31GN,ATURE: �___ r�� RE�ISTEReD Y I N � � FZE CURRER Y I�J
<br /> _�� .e z r � �
<br /> ---------
<br /> ___ ._. _.
<br /> Iti�dress �� Licensc�# C� � i
<br /> __.�.._.�._._. _ ..�._ .� ` �__.!
<br /> --.��- �.-- �._ --______�..�. ._.. _.._.
<br /> �THE:Ft COMPANY � __.._ .._..�
<br /> iIGN�4TURE __�__ �� �_ ftE�iSTERER Y/ �} r FCE CURREt� �[ Y 1(��
<br /> l�ridres� �--,�._�_� �_ ^ � Lfcens�# C� � ��.�
<br /> i-f-htittttf-h@�'�t-t-Fi-titi•�t-fft�i-ft�tttt�Nii-t-t��t-FtifiFi-t-FH-1�f�i�tt�9-ii�t-H-H-FFf�Fi-tf�f+Hi-Fti�i�t-Ftti-ti-ti-i-i-YfiitH-hhh�t+f�t+hf-FFhi-li-f+Hi�fi-t�fi+f�Hii�+ifiii-f�l
<br /> tESf(?lENTltet. latt��ch{2}Ptot Plans;{2)sets a€Bullding Pians;(1}set pf Energy�=orms;F2-O-W Perni3fi#or new construc#ion,
<br /> (vllnimum ten{10)worklnc�days after submftt7!data. R8f}UIIBd 4t3S{tEa,Gonstructlon Pla��s,Stocmwater Plans w!Slit f=ence lnstalled,
<br /> :ianitary Facllltles&1 dumpster;Slte Work f'ermit far subdivlslpns/larg�a proJects
<br /> :OMt�tERCttil. Atts�ctt{3)comp(eke sets of 8u(Iding Plans plus a Llfe Safety Page;(�i).�ef of Enerc�y F'orm:;, R-O-W Permlt for new cbnstructlon.
<br /> Mlnlmum ten{1 Q}workfna days��fter.sR�bmlttai_date.-Req�frad-ansif::,-f;anstructEan�Piar�s,Starmwater Plans wl 8i(t#�ence instalVed,
<br /> - :iariit�iry Fac(1lties 8�1 dumpster.Site Work F'ermit fnr all neiw proJects.AI!commerclal requlraments must�neet compllartce
<br /> �iGN P�ERMii' Afts�c�i(2}sets of t�nglne�red Pl��ns.
<br /> "'"''PFt01'ER7'Y SURVEY raqulred for all NEW construction,
<br /> c�IxmT.t7:]SnZitXfir.Il�1�Cm�i7?�=11�Izl:ti�27������Lt�i�}���II:p��tiTSII:LI��B
<br /> iiroci;l��ns;
<br /> F ill out aF,plic;aticsr�comGyle#e(y.
<br /> C)�vner&Contractor sign back of agpflcatlon,nc>tarix�3d
<br /> Iif�over$;!SOi), a Motice of Cammencement is requlred. {A/C upgrades over:�750�Q�
<br /> I
<br /> F�c�ent(fciv thi�oc�ntrac;tor)or!'ow�r of Af4orney(far kha owner)would be s��meone with notarized letter�frarn owner authorizing same
<br /> ' �VER.'('HE COU��T(:iA;P�:RMITTING (1=ront of Applicatlon Only�
<br /> eroofs:lf shingle�o Sr�wers Servlce Upgrades A/C Fences(Plut/Survey/I=ocatage)
<br /> C�rivewayrs-Rlot over Counter if art pubiic roadways..ric�eds ROW
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