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Building Department <br /> Date Received ✓ Phone Contact for F' 'ft* ( API 7H -53'P( <br /> & A <br /> Owner's Name d9— a—a -ep—,4Z&le�t— Owner, PhoneNumber 131s— 6&1 f <br /> Owner's AddresS IrJIS Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS <br /> LOT It <br /> SUBDIVISION YM 14-of iijs��,4es PARCEL IDAF/ --26-02 e6&JO-I61167 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEWCONSTRF;—,K ADD/ALT SIGN DEMOLISH <br /> R INSTALL F-1 REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME STEEL <br /> DESCRIPTION OF WORK <br /> y=BUILDI IZE SQ FOOTAGE[ a. HEIGHT <br /> -r* , I r-r"r . . . . . . . I I I <br /> UILDING VALUATION OF TOTAL CONSTRUCTION <br /> ZJ 6 1 it <br /> 0 <br /> AMP SERVICE PROGRESS W.R.1 <br /> ELECTRICAL $ EC <br /> =PLUMBING IS <br /> VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I" <br /> . . . . . 44_; .4.4— <br /> BUILDER COMPANY I WUA&t)&�V7 Lo 1'% <br /> SIGNATURE yt REGISTERED Y/ N FEE CURREN <br /> Address License <br /> ELECTRICIAN COMPANY EaJ;P41'ell, 16 <br /> SIGNATURELEI REGISTERED YJ N FEECURREN LI_LN J <br /> Address 44 2WAS License# F <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I YIN FEECURREN Lyl N_J <br /> Address I License# <br /> MECHANICAL COMPANY EM:' <br /> e47kJ-'-'7 L SIGNATURE REGISTERED YJ N FEE CURREN Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEECURREN <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsits,Construction Plans,Stormwater Plans wt Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsliarge projects <br /> COMMERCIAL Attach(2)complete sets of Building 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 wl Silt Fence Installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plan$. <br /> —PROPERTY SURVEY required for all NEW construction. <br /> . . . . . . . . . . <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> if over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized lettei from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter,!on oublk;roadways..needs'ROW <br />