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<br /> tiuiic}Ing vepaft�neni
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<br /> Date FteceivEidl M �,.i��� 1 �'Y1 O nJ !C f�1
<br /> Phone Contac�fof Perrriitting Z� —� f�, .
<br /> �zrnrm=� .�n�:�m".�]�2]sr��t�rta�st �=t���i��a�_..._._.__.�..,_._._... �
<br /> .
<br /> Owne�'s Name !C;��_�;�,��r ._... Owner Pho�e Etum�aer �l� ^`�q— f'Z p 7 _.._�
<br /> ' ; _.,�_... � _.._,�
<br /> Own�ev's Adoln�ss� 1�_�_���_�1A2, ��� �� Owner Phona Number C �� �`
<br /> Fee:'slmpfe 1'itietiolder Mame C _��____� �� �Owner Phone Tlumber �T� �_�,�
<br /> I _....,._..._... _._.. _.___..._, .�.,_.�_....�
<br /> �ee;iimple i'itlettalder t�.ddress � � ���
<br /> ; �._. � _._._. _...._�. .�.._..
<br /> JOB�DDF��:S!> I L-��1'�1�&s�-e-Z�h�-1—��-�-�--�-���-'�____� � LO�`# L .��.�
<br /> ; -- --_.._ _.._..._. i-...._.�
<br /> SUBIDIVISION f �e,)/.AA 'X%+yl �5��.�-_.� PARC�L!D#C2�7_(0`-'2,� j.. ?�„�"����'�.�..CS r�-
<br /> ; (08TAINE:b 1'I�OM PROPERTY TAX NQ7{Gtc}
<br /> WOR,N:pRDF'CiBE:D i NEW CUNS1'R ADD/ALT ��� SIGN !_� C� DE:MC►LlSN
<br /> i E� INSTAI_L. » REPAIR
<br /> PROIPOSED U;�E ` C� SFR �� COMM �_� 0'T'HER �_� �� w.�
<br /> TYPE:�F t,ON;STRt)C'tt��N C� B1.00N; �� FRAMr �r� STEEL �_� C��� �__,�
<br /> ��sc�iRIPT10�r�or-wo��; C��Q�...��_ _���.ui�` ��e.��2��'L 2Z-S"/ 3�� ��`-1 t��m 6���i
<br /> � ...�.
<br /> ��8UlLI�lNG SlZfc C ��_�^� ;5t�1-pOTAd�E�,��� H�tGH1" � �
<br /> :L�F�1:177�t7�3�l�F�GFi�7�13:]�C377�I�TiI7�i�[���F�i�i����I�7-� �t�i��I�iI�AI7
<br /> [�E3UILI�INC:� '' �������� WAI.UATION 01=TOTAI.GONST'RUCT'it7N ',� t �,''�"�
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<br /> [_�E:L.I:C;TFtIi;�AI. ($ —�� AMP SERVICE �� F'ROCRESS ENER{�Y �] W,R,E:.C,
<br /> �
<br /> [T�FLUMBWC3� (�' ��
<br /> ��
<br /> [._�MECf-1ANl(�AI. ($ —`� VAL,UA710N OF MECHANlCAL INSTALLf�TlON �������
<br /> I
<br /> �� �1
<br /> [,�GAS � �] ROOFINU �� SPECIALTY �_] 07HER
<br /> 1=1N151-IED FLO(aR E:L.EVA'T'IONS Fl.00fJ ZC)NE AF2EA ��YES NO
<br /> ��—���
<br /> 11-t-t-t�ff-ti-tthtt-F-Fi-Ft-ti�-t-t ti-ti-�+tith�Fh�fi ' ttHfihil�ttHi-fi�t-tii-t-rti-ttii•itFf-4li-tri-ht-f-hPttt�FHt•F1-tf-I-l-ti-t-t+f-ttttttf�f-!tt•t-H-Hft+l-t-Ff4t1�f
<br /> . ' _ . ° _ � . .,.,
<br /> 33UILI[}ER � � ` n_� .� CC)MP'ANY ���0 W�e,S- d"t'bMe �'1VT�,. �L.t. ���
<br /> :iIGMA,TURO� ,�'�?����'(�p(J'� (1FTW3!?O�� REGISTERED Y/ N � F&E CURRER������.I
<br /> ,adare ys !_f'o_C�o�7�t��i 3 ���I A�rei� �� '3 t87�' l.icen:;e# C,G �-�o��yl � � �,�
<br /> — - ._...� � _
<br /> _.� ,— _ _.._ ._�. .__.._... _
<br /> E:LEC;'i'RICi�IV � CC)MWANY
<br /> �� _�. ___.�
<br /> >lGN�1TURI:: ,n � _�� ^�`v � REGISTERED Y I N T FEE CURREt�� Y J�r
<br /> i4�ldress �__ ._...i.�.. _�_ _, ._._.� Llcen�e# � �J
<br /> Pl.UN1E3ER —.,_.^.r� �__.__ Ct7MPANY � ^.._�. y ^ _..__.__.�
<br /> atGN.ATl1RF: __� _��^��___ REGlS7EREQ Y t N r Fr_�cuRR�n� Y t�
<br /> l���dress E__.�,._�� __��- — �� Llcense# C� � ���,
<br /> NEGt�r�NIC�'i!_ � � CCiMPANY � �_T_ � —.- �_._..�
<br /> iIGfJ,ATURE: [_�_^ _�__ REGlSTERED Y/ N FLE GURREh Y/�l
<br /> __ z r � �
<br /> i\ddress �--��—,�,r ` �� Licens�# CT_ � �,.�
<br /> 3THEsFt r_ „ ._ CONtPANY (�_,..�._.._=� i...�
<br /> iIGN�4TUREi � _� REGISTEttED Y I � fEE GURRE� Y/EU
<br /> -- --�______�... �_ z�r � �
<br /> t\dd1'es3 �----._�u.. .i`_ � ] Licensa# C, � ��....�
<br /> i-t-i--t�i-f ttf ti-FatttNtititti�tG-Htt-tftfFtttf-Ftittti-Hi+f+i�-i�f-ti�f-tti�ti•fii-Fi-�#+�i�ii�i�ti-i�ii•t-FF+t�fH+Ffii-1-�f�ttfi+FH-Ffii-HtHii-l-fii-fiiiitt-H-ti+Hi-f-Pi�f�f��
<br /> tES![)lENTI�a!_ Att�ach{?}Plot Plans;{2)sets of Bu31ding Plans;(9)set of E:nergy F=orms;t�-O-W Permlt for new construcfion,
<br /> �vllnimum ten(10)workiny days tafter submittal date. Required onslle,C�onstruotion Plans,Stormwater Pl�ns w!Silt Fence lnstalled,
<br /> 5anitsiry Facllltles&1 dumpster,Site Work Permit for subdlvisions/larg�proJects
<br /> :t3Mt�AEF2Ci�L Att�3ct�{3}complete sets af Building P(ans p(us a Life Safety Fage;(�1)set of Energy F'orms, R-O-W Permlt for new cbnstructlon. __ I
<br /> - t�li�lmum fen{40}worklnc�days F�fter:submitta!date: Rsquired�onsit�a;t;onstructio��Plans,-�Stormwater Pians wl Stlt i�snce instatied,
<br /> 3anitsiry Facilities&1 dumpster.S(te Work Permlt for all ne�w proJecks.All commerclal r�qulremenks must meet compliance
<br /> �tGN P"EF2Mt7' /�tt�icfi(2}sets of 1_nglneared PlFtns,
<br /> ""`„PFt41'ERTY BURV�Y requlrnd for�!f NEW constructlor�,
<br /> [IT22SLTSSL�:]TS7x2!?iIIYSlS�S�7.LICA�SL�ZLC�a2�1TT'�T�"��IT:E7����7t�LLC��TL%
<br /> �ireci:i�ms:
<br /> F�Elt out a��plir.aflcan camE7fetely.
<br /> Uuvner 8�Coa�trackor sign back of application,nntarizisd
<br /> lif�over$:!50i),a plotice of CommencE,ment Is required. (AIC upgrades over:67�n�)
<br /> P�gent(fov th�s contrac,tor)or Pow�r nf Akforney(for khe owner)would be sc�meone with notarlxed lette�r•fram owner authorizing same
<br /> �VER.'�HE Cf)UNTl��:P�,ERIV1lTTING (1=ront of Application Only)
<br /> eroof{,if shingle�c 5r�wers Servlce Upgrsades A1C Fences(PIc�USurvey/�-aotage)
<br /> Clrivewal+s-Plot ouer Counter if on publio ro8dways..ru:eds f20W
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