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Building Department <br /> Date Received 3 + 8J, — <br /> Phone Contact for Permitting' ail <br /> Owner's Name �>-V 'a- ' ' `asb.o 77""OwnerPhonhone Number U� " 71 � <br /> Owner's Address I`��e dsl`^'� + +� �QM�6n Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> I <br /> Fee Simple Titleholder Adddreess JOB ADDRESS F31033 l ' u o` o r� ��t�l S LOT# I <br /> SUBDIVISION I I Val � t1 PARCEL ID# + �`��0-a 1 ,bb 6 "dCCbb- bb'ib <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED-- NEW CONSTR ADD/ALT SIGN Q MOVE DEMOLISH <br /> INSTALL REPAIR j f <br /> PROPOSED USE . [� SFR COMM 0 OTHER <br /> TYPE OF CONSTRUCTION ' Q BLOCK FRAME 1^ STEEL <br /> r Q OTHER <br /> DESCRIPTION OF.WORK <br /> BUILDING SIZE. SQ FOOTAGE HEIGHT <br /> ®/BUILDING a$ r, .: ��l J VALUATION OF TOTAL CONSTRUCTION i <br /> 1 <br /> Q ELECTRICAL $ AMP SERVICE 0 P{ROgREPS ENERGY <br /> .J , <br /> Q PLUMBING $ !/ C9. <br /> n <br /> 0 MECHANICAL $ 40^ <br /> VALUATION OF MECHANICAL INSTALLATION � <br /> 70 <br /> �] GAS ROOFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES =NO , <br /> __BUILDER_ COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT YI /N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N ' <br /> Address License# <br /> I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> MECHANICAL CO PANY <br /> SIGNATURE E TERED L Y/ N FEE CURRENT Y/N <br /> Address /% License'# <br /> OTHER �n J (j �,/l ( COMPANY Q `�' L " <br /> SIGNATURE OA I ply- `� v�'v�` - REGISTERED / N FEEC RENT /N <br /> Address 3col 6 5 r 5y 1`S C� 3- S License# L!CC�, SS�� ILI <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 onsite,Construction Plans,Stormwater Plans w/Slit Fence installed; <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL, Attach(3)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_ onsite,Construction Plans,Stormwater Plans w/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 Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <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$5000) <br /> ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> 'OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences'(Plot/Survey/Footage) k '•• r �'-''"� ' <br /> - .•s tiT>-. ...�. j� ' ...+1•�: '7�19.• ..e:tr i•:. n <br /> ^,tit..,,...:' "_• ..t.. . � <br /> Driveways-Not over Counter if on public roadways:.needs ROW <br />