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Date Rar, i 1,hone Contact for Permitting LT= LU.7 <br /> Owner's Naniti a Owner Pha <br /> se dumber ' <br /> u� <br /> Owneir's Addresu Owner mumbet [—_._. —.._ ___ ____.� <br /> Fee Simple Titleholder Name C__»—»_ Owner P one lumber C���,�____.___._1 <br /> Fee 3imple Titleholder Address <br /> JOB ADDRESS i: E LOT SUBDIVISION �UL1a,N L%.r U <br /> PARCEL ID# <br /> (OBTANIMI'l,01A PROPERTY 7 -N-0TICI-:) '--"---- <br /> WORK PROPOSED ,: NEW CONSTR ADD/ALT F--] SIGN F" E-1 DEMOLISH <br /> T <br /> El INSTALL REPAIR <br /> PROPOSED USE SFR Comm o"rHE <br /> TYPES OF (','ON:STRU�'rI0N BLOCK FRAME. STEE, <br /> DES(11RIPTION 01"Wom' I-Lg� <br /> BUILDINclisin Is()FOOTAGE=----]. HEIG 1" �� __ __) <br /> EIL11LDINC-1 <br /> VALUATION OF TOTAL.CONSTRUCTION <br /> AMID SERVICE F' OGRESS ENERC3Y C,j W,R,[:,C. <br /> PLUMBING! <br /> MECHANIC AL $ VAL,UATION 01:MECHANICAL INSTAL(A ION <br /> GAS, ROOFING SPECIALTY 'OTHE_� <br /> NO <br /> INISHED FLOOR E:L.EvkriONS FLOOD ZONE AREA <br /> H I*ttt-�ft!jtJ;I 11 1 1 i-H1 11111 fffi+�ti f- tl-11 -H+i-Htfi-H-H-ftttfli+H-I-FI'-i 11 1 l`t4+f-t+t1 <br /> ........... T i Z, <br /> �4 T <br /> ELV:3L (ne <br /> UILIDER COMPANY L&-, ir.� <br /> IGNATURE �jnj ot Ll; REGISTERED '-'y-1 N F-. TC(U;R—R EE N Y/N <br /> Addrei.',-s C?)o?,k -7'8 191 tivt� 2 3?79' #IJ�cjnse <br /> -ECTRICIAN COMPANY <br /> �.�..._._ ,,-GRATURli REGiREGISTERED7-77-N-i FEE CURREN <br /> Y <br /> L Ic, n8a <br /> Address <br /> .LIMBER COMPANY <br /> 3NA REGISTERED —,N T--TF1-.T'7U17RET--1—Y I-N <br /> Address Lice so It <br /> COMPANY kNICAI. REGISTERED _11 N IF-7FEF(ZU-F—RFT"- <br /> 33NATURE 7=YIEJ� <br /> Address License <br /> HET I COMPANY E <br /> ',NATURE: REGISTERED Y/ I:FCURRFtl <br /> Addresi'.; Lice <br /> -VT+Ff*I-i H-i+H-f+-H+lrI 1111!+H+H+H+H-H I H <br /> 31DIENTIAl. Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W FEE milt f;r new construction, <br /> Minimum ten(10)working days Ilftff IUbmItU'.tI date. Required onslie,Construction Plans Stormwater Plans w/Slit Fence Installed, <br /> -anI'try Facilities&I dUnripster;Site Work Permlt for subdIvislons/Isarge projects <br /> MIAERCIAL Attact' <br /> I(,,,)complete sets of Building Plans pIU13 a Life Safety Page:(1)(let of Enero Forms, R-O-W Permit for now conslructlon. <br /> IvIln1m,urn ten(-10)working days jifter iqlomitti-il,date..Required onslto, <br /> . Construction'Plans Stormwater Plans wl Slit Pence Installed, <br /> "3ar1ft"iry-Fac1IItfW&-1 d6faiter, Site Work Flermit for all new projects.All comai.pre at req Ireryients rriust meet oompllan.ce <br /> N PERMIT Attach'l(2)sets of I-Engineored Plans. <br /> """"PROPERTY SURVEY required foraill NEW construction, <br /> :11...IMM%M <br /> F:ili out application completely, <br /> Owner A.ContraotorrIgn back of application,notarized <br /> N over$2501), it Notice of Commencement Is required. (A/C upgrades over 11171.500) <br /> Agent(for the conlra*tor)or Power of Attorney(for the owner)would be someone with notarized let fro 11 ow "er f n owner authorizing me <br /> fro <br /> RTHE COUNTE.R 11.1.RIMITTING (Front of Application Only) <br /> ofs;If Shingles s6wer!" Service Upgrades A/C Fences(Pict/Survey/Footage) <br /> i <br /> [)riveways-Not over Counter If on public roadways.,needs ROW <br />