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513-780-UU2U City Ot Gepnyrriiiis Permit Application t-ax-uis-rsu-uvz-i <br /> Building Department <br /> Date Received 23 7 7 ,7 <br /> Phone Contlet''for Permitting <br /> Owner's Name Z US ` U'(til 1Z 9 w6sw y/ e-&J J / Owner Phone Number 7a ? Lt Z <br /> Owner's Address &-A /lam 8k drGJ-4-- S 3T Owner Phone Number <br /> Fee SimplelTitleholder Name Owner Phone Number <br /> Fee Simple;Titleholder Address <br /> JOB ADDRESS F7 4 ZZ ei C_ ff 9 Z`!," �� �► l�/r S ! 37� LOT# <br /> SUBDIVISION 120( IG !H/V PARCEL ID# . <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH <br /> R INSTALL a `REPAIR <br /> PROPOSED USE. Q SFR = Comm = OTHER <br /> TYPE-.OF CONSTRUCTION = BLOCK = •FRAME = STEEL 0 <br /> DESCRIPTION OF WORK P I CCU 02 on, 0 C)M_i D`/1 ! d sty/ TS (S -Tokf <br /> r, <br /> BUILDING SIZE SQ FOOTAGE HEIGHT •. <br /> =B'.UILDING $ VALUATION'OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY Q W.R.E.C <br /> =P,LUMBING $ 6 � <br /> LpiMECHANICAL G VALUATION OF MECHANICAL INSTALLATION$ <br /> 3° s <br /> =GAS = ROOFING- Q. SPECIALTY = OTHER i2 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N, FEE CURREN <br /> i <br /> Address [ _ 'License • : <br /> [[[ LECT. C `� C9 PAN <br /> Y _� - _ �j <br /> S ATURE n �,CpNATU _ EGISITERED `�i��Y/'N'' FEEiGURREP y ' <br /> �l Address- <br /> � <br /> Address' � - License# <br /> PLUMBER.:: COMPANY <br /> SIGNATURE REGISTERED Y-/'N- FEE CURREN Y/N <br /> Address z � License#, . <br /> MECHANICAL p Y �6V lh A-f. <br /> SIGNATURE'`' R GISTERED Y/•N FEE CURREN L Y/N ' <br /> Address_•=' G ,��S v 7 license*_ <br /> OTHER. COMPANY <br /> SIGNATURE;< REGISTERED Y/.N FEE CURREN Y/N <br /> Address;;,. 'V,.r::. Licerise# <br /> "::..RESIDEPIYIAL;:: si4ttach"(2)PlodP_,lans;=(2)�sets�of Buildlrig'1?lans;(1)°set of�Energy:Forms;•R;Q-1N PeRnit.for newr.constiuction; <br /> :Mmimum ten(10),workingpdagS'after`submittal:date.:Required'onsite;Construction Plans,•Stormwater Plaits w/Silt Fence installed, <br /> Sanitary;Facilities&1_.dumpster;SiteiY.ork:Ptrmit.for.subdivisions/large'projecfs.: <br /> 'a;COMMERCIAL Attach(2)-complete sets`bUllding Plans plus a Life Safety Page;(1)set of Energy'Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, j <br /> Sanitary Facilities&1 dumpster_Site Work Permit f&'all-new-projects.All commercial requirements must meet compliance <br /> `.=10I6N'.PERMIT "Attacfi(2)sets;of Engineered Flans <br /> *""PROPERTY SURVEY re wired for all,NEWconstructiom, . <br /> ,Irectiorts: <br /> >Fill'out'application completely. <br /> Owner'.&Contractor sign.back of application,notarized <br /> If over:$2500;.a Not)ce.of:Commencement is required. (A/C upgrades over$7500) <br /> •'' Agent(fora&&coritractoT),or:Powerof Aftomey(for•the owner)would lie someone with notarized letter from owner authorizing same <br /> <:OVER.THE COUNTER;PERMITTII Q.,. ...-...,(copy..of,contract required) <br /> Reroofs if s i 9 s--Not over ewers .Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> y ies Counter if on public'roaiJovays:.rieeds.R01(V.. . + <br /> S.0', . <br />