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513-780-0020 city of Lephyrfuls Hermit Application sax-nos-sou-uur� <br /> Building Department <br /> Date Received <br /> Phone-Coilti ct�for•Permitting <br /> Owner's Name Owner Phone Numb ( al <br /> Owner's Andre Owner Phone Number <br /> Fee Simple Tltleholder Name`• @' Owmer`Phone Number- <br /> Fee Simple Titleholder Address <br /> JOB 14DDISb RESSI� ;t S/x— LOT# <br /> SUBDIVISION PARCEL-ID#; <br /> .(OBTAINED FROM"PROPERTY.TAX NOTICE) <br /> WORK PROPOSED NEW:CONSTR' AD.D/ALT 0 SIGN [ Q" DEMOLISH <br /> I . INSTALL. 8:; REPAIR <br /> PROPOSED.'USE• - 0 SFR Q :'7COMM Q` OTHER <br /> TYPE'OF CONSTRUCTION 0'. BLOCK 0 'FRAME Q. STEEL :,=. <br /> DESCRIPTION OF WORK ®(F fyp y,�f y osZ 6e C <br /> �. G0 �0 <br /> BUILDINGiSIZE SQ'FOOTAGE_ .HEIGHT' <br /> 1 <br /> BUILDING VALUATION'OF TOTAL CONSTRUCTION ' <br /> ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C. <br /> r _ <br /> [PLUMBING, $ - � <br /> [MECHANICAL $ VALUATION OF MECHANICAL.INSTALLATION <br /> =OS 0'. ROOFING. Q SPECIALTY. O OTHER >� <br /> FINISHED:FLOOR ELEVATIONS FLOOD ZONE AREA AYES NO <br /> :BUILDER ash COMPANY <br /> SIGNATURE REGISTERED Y-/ N :FEE:CURREn <br /> Address License;#` <br /> ELECTRICIAN COMPANY -=:SIGNATURE REGISTERED Y/ N -FEEidURREh.. . . Y/N.J. <br /> ' <br /> - , <br /> Address License#, <br /> PLUMBER '... COMPANY:-':: <br /> SIGNATURE ' REGISTERED -Y/ N '' FEE GURRED,: <br /> Address. :' Ucen'se;# <br /> MECHNPIICAL .COf p;P kNY <br /> SIGNATURE:, REGISTERED Y/.:N 41 . FEE_CURREh- <br /> Addfees�':;::... <br /> COMPANY.-.': <br /> "''SIGNATURE < AidISTEREo Y/N FEE cuRI;m Y/N <br /> ;Address. , <br /> G-. RESID.EN+ fAL''^ <;A -.chr 2; Rlot;P:aans :2,sets°of Buildln/shlans;`11 set of Ener/ /Forms;R O.W;Permit:for• ristruption,:,y` <br /> `r:: :Minima %ten 10. "ockin`:da'' after` ubm`ttaidate: Re aired onsite Constriction Plans Stotmwater Plans w/Silt Fence installed; <br /> _ - :,it1•Y(1 �^�;JiL... _ _ _- <br /> Sans acilitles°&tcdum ste%51 ,W..ork;Permlbfors"ubtliirsiops/a� e` ioects;- <br /> =r ,C0MMERCIAL AttdW(2)-complete sets ofEuilding�Plaris plus a'L1fe Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructions <br /> Minimum ter*(10)•working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed, <br /> Sanitary.Faclllties.8:1 dumpster.SIte,WoriC Permit fog all=new:060'cts.All commercial requirements must meet compliance <br /> ;::SIGN:`PRiYiIT "Attadli(2)sets;QfEij9ineereda?lanss=-:.r,_ ::, - <br /> c ""PROPERTY SURVEY reguired_f9G411,NEVV construction._.. <br /> Fill'out application.completely. <br /> ,::.. . <br /> ': . <br /> Owner&,Contraotor`sigp:back of application,notarised <br /> 'If ovi r:$2500;.a.Notice of.Commencement is required. (NC upgrades over$7500) <br /> ,;.• ;. Agent;(f6e'the'conpa61:40.) r Power`of Attomey'(for'the'd*he�r)would°tie someone with notarized.letter from owner authorizing same <br /> -°a: +OV•ER'•.THE>COUNTERPERtv111TING,::.,.•-:._,..(wpyofcontractrrequired)--- <br /> .,.,,..- ... <br /> ;,Reroofs.ifatiingles `Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> =DHVeways-Not over Counter If on pdblic`fbadways needs ROW <br />