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; <br /> Date Ftecelve;di j _ I <br /> Phone Contact for Permitting 3 2 t'e 4 lt7dnEiGR <br /> stzmst�zr�i2L"[ ttLtt-at x� fia12LL17C <br /> I bar '� 3y,( qCwnP liOwner's Name <br /> .. —••••i <br /> Owner's Addreslf +_ �o0i3 BPA✓�+ Owner Phone-hlumber C �� <br /> Fee Simple T'itiettalc{er Name.. L � {)wnar Phone f+lirmkrar <br /> Fee SimplaIltiet`ioider Address <br /> JOB ADDRESS i Cte 0 c�.�dG�►�,<c _ I LOT#. <br /> SUBDIViSION � Ct Y�� 2cPhaytirtl5 �� PARCEEL lD#C3�."2S' <br /> (OBTAINED FR PROPERTY TAX NOTICIi); <br /> WORK'PROPOSIiD F 4 NEW;CC)NSIA ADD/ALT C,] SiGN {�� C{ :, DEMOLISH <br /> I INSTALL REPAIR <br /> PROPOSED USEi C ' SFR COMM OTHER (^ i' <br /> TYPE OF CONSTRUdnON C� BLOGK FRAME STEEL <br /> DEst,iRtiPTiON 4F WC)RN; Chat!_LZ..� b4 <br /> ._sGf_ �4 <br /> 31,1I1-DING SIZE ;5Q' 0gTAGE ' I i ti)~tC3N1" <br /> r��r�uz�E� s�rus�zs���t�tu .�ru :t�rt� s�ia�xzi�t�i:�xxui�ca� <br /> [ E3UILi31I�GI : $ ' VALUATION OF TOTAL CONBT'RUCT'IO"ZAN <br /> [_7E:L(.C�TR1K',AL $ AMP SERVICE F..RO{C�RESS.ENERC?Y:., W.R.E:,C, <br /> [_7PLUMBING (g <br /> I L <br /> 1_.7MECHAr IQAL $ ( VALUATION 01:MECHANIC AL'INSTALLATIQN: <br /> E.-7 GAS i C� ! ROOFING .t� SPECIALTY �_] OTHER <br /> INIShIEU FLOOR E:LEVA'1 IONS FLOOD ZONE AREA C.1YGS I NO <br /> tt-t•titt iti-tttHt i tti+i tttt i-t ft i-hi-Ftfttt-H t tit ttti tf ttti f fttt�i'Pi t f l-t t�Fit f f-!1 t-!•tti ti ti t t;Fitt hH t+ti t tt 4 Ff+i f <br /> UILIDER _ COMPANY Lo I40ji e G Te.r� <br /> IGNATURE. ,�eP-- REGISTERED <br /> Address I_I,[ .8 a r18 I' �3_f (:.l AtQJ m .rL 3 z$j?fit Llcen:e# <br /> _EG 1RICIA(V C{)IMPANY 1 _ <br /> GRATUREE I REGISTERED Y i N T FEE CURREN <br /> Address i _ .._ Llcen e# <br /> .UN113EIR ; COMPANY <br /> 3NATURE V _ _ 1 _ REGISTERED Y/ N r Fi.E GURREA Y,/,N, <br /> Address �_i _�� �_ -� � License# <br /> ECFii4NICAl» COMPANY C <br /> 3NATUREE y_ REGISTERED Y/ N T FEi CURREN YIN L <br /> Address [_!- ( �; Ltcans6# <br /> HER - `. ... I l � . COMPANY �_�+ <br /> WATUREE REGISTERED Y/ N r FEE CURRE� Y/ <br /> Address �^i -i __ . i Licons;1,;iFf+f i t+t+�iFt t t+tiitt Ftft ti+fii+l I 1!1 -i+!•t-kf•Ft+j H+f 4-t•tt-t•Ht -t•+f <br /> ++H t I 1tH 1 1+t-H-F+l 1 Ht 111 ttttFttFt i f-H ftF f+I h1 i H'Ii HH ti i4f-f <br /> SIDIENTIAL Attach(2)Plot Plans;(2)!sets of Building Plans;(1)set of Energy Forms;R-O-W.Permit for hew construction, <br /> Mlnlmum ten(10)working days/after submittal data. Requlred.onsite,Construotlon Plans,Stormwater Plans W Silt Fence installed, <br /> :3arift try Facilities.&1 dumpster;Site Work Permit for subdivlslonsharge projects <br /> Mt�iERCIAL Attach(3)complete sets of Building-Pl�ns_plus_a_Life_Safety_page;.'(,I)set:of-Ever y-F-'orms]R-'O•W-Permit-for-nsiv:cbnstruction. <br /> - -'MI'ii rr ui ten{1g)w rkiny days sifter s[ibmiifai date, Required onsite,Construction S�tormwater Plans wI Sllt franca Installed; <br /> >anitary Facilities&1 dufnpster.Site Work Permit far a!I new projects.All icommerclal requirements must ineet compilance <br /> N PERMIT Attach(2)sets of Engineered Plans. <br /> ---,''PROi'ERTY�SURVEY-required for all NEW construction. <br /> I22I I2 Lfi3�I7ID:iZi7CLt?3 St3�2t7x7%I7� MXP=3Lt am Inu== == [I3]:��CLB <br /> +ctlons; <br /> Fill out appllcatlon completely. 1 <br /> Owner&Contractor sign back of application,notarized <br /> Ili over'$2500,It Notice of Commencement is required. (A/C upgradas over$7500) i <br /> Accent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from;owner-authorizing same <br /> :R.'rHE CO NTE R PuRMITTING (lT rout of Application Only) <br /> loft;If shingles 1 Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Ctriveways-Not over Counter if on public;roadways:,rieeds-ROW <br />