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__n..0,a vvrJnI UIIQI II <br /> -YIOWI LA <br /> Date ReGelHaltll { Phone Contact for,Permtttin' �6 I Z16 —�� <br /> Ii�allC t[] Ltl ®Z3' 1'L 27S7Ctt rr!t ?3� <br /> Owners Na .;- 1 (� 1 Owner.Phone lulu. <br /> me ber '�b13 <br /> OwneJ's Addres;L. J� c�S 1`�.1^/ 5T___&_ �i' 5 _ awner Phone'Number <br /> --- <br /> i <br /> Fee Simple Tltlelllotder PNama: C { tlwner Phone.Nil' kier <br /> Fee simple Titleholder Address I. <br /> JOB ADDRESS <br /> I C52 YS ki+ ',err 2�h;11S "[L 335`/2 ._..I.. LOT#, <br /> SUBDIVISIONC. '�}� PARCEL iD#t <br /> '�'�` --- (OBTAINED Fiko' )ROPE RTY TAX NOTICE). <br /> WORN:PROPOSED j NEWtCONS7'R ;ADD/ALT C^7 SIGN I____t :,CI ;; DEMOLISH <br /> INSTALL !� REPAIR <br /> i PROPOSED UI9Ei C� ,8FE2, (= COMM ��� o.174 (: i <br /> 7YPEE OF CONS7RUC'CION C� i, E3LOCN; I� FRAME Ci'� ,i STEEL <br /> DESCIRIPTION Oli WORN; C S/A 11: 1�o7r U'�, "��Aitt1 �ii,�Z��L� <br /> 3UELIDiNG SIZE i...r__ i :: � 13Q FOOTAGE ! ` , ' '� HlciGHT' L•_ :i ' . I <br /> �I>=f�1:IX�I�I��r�F[x��i� t�F.i3�z27�3��tI .�� A�i�1 �17q� i�Fllx�lf� <br /> [4BUILiDIN G �$ VALUATION 01:TOTAL CONSTRUCTION j <br /> [_7ELi_CTRIC.At. AMI?SERVICE �. F'ROPRESS ENERGY:. W.R.EE.C. <br /> { <br /> DPW <br /> } <br /> [._7MECHANit:AL $ ; VAL,lJATI()N OF MECHANlCAt:lNSTALLATION <br /> [_ GAS I �� i ROOFING ',SPECIALTY OTHER <br /> INISHED FLOOR EILEVXriONS. i ;FLOOD ZONE AREA ,: =YES NO <br /> t li ti+t#ti-Fi t-t t ttlli 0 i t ti H ti Et�itti t tti ti ttf tii f ti t i ti i-litti htttt t t f t ti-f t fttf t 4i t l l-FttFi H H-H ttttttttt t t hH-H ti i tuft ti f <br /> UILIDER Y COMPANY tlxE,�l�s I"tbft'1 i" L L :. <br /> IGNATURE. _�{ � i�oNi`af G lao' REGISTERED { . Y/ N FEE CURREN Y <br /> Address I``3D_SoO L _P8 19,9 3: b �?.IArJ �t� fit. 32�?�' Llcen;e C G I:SV.7 <br /> _ECTRICIAN �- I COMPANY _ <br /> GN.ATURIiE , I REGISTERED Y/ N FEE CURREt. Y'/N' <br /> ___ _ -ZIT � <br /> Address � ` License# <br /> .UNII3ER COMPANY <br /> 3N,ATURE"s REGISTERED Y/ N FEE CURREN Y/: <br /> Address i _ _ _ u ; License# <br /> :CHANICAL COMPANY <br /> 3NATUREE REGISTERED Y/ N FEE CURREN Y <br /> Address LIcbn`se# <br /> NEi Y/ N r FEE CURREN FI ,I , i , COMPANY. L �__ <br /> KNATURE I REGISTERED '—'[. Y/N� <br /> Address [_!. _ { License# <br /> FH-f 11 111liltl-htti4ii•t•Fi-+ tl•H+tf ffi-ht H I HittttFfi tf t 4ltttfii-I tfi f tit Ft...tit i f Fi i fi fii t l fiitti i-hH-tttt fii-t i-t t htti t-Eiiit!-ti tttfiii fifltt <br /> SIDENTIAi. Attach(2)Plot Rians;(2)sets of Eluliding Plans;(�)set of Energy Forms,�-6-W Permit for new construction, <br /> Minimum ten(10)working days Aer submittal data, Required onsh,C:ortstructlon Plans, Stormwater Plans w/Sllt Fence Installed, <br /> Sanitary Facilities&1.dumpster;Site Work Permit for subdlvlslons/large protects <br /> MfdEi2CIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)Elet of Energy Forms,R-O-W Permit for new construction. <br /> _ Mipimum ten..(10)working_days.afteettiabmittel date._Requlred-onslt(t,<C.onrtruotion-Plans-Stormwater-Plans-w/-Sllt-Eience-installed, <br /> aanllary Facilities&1.duinpster.Site Work Permit for all how protects.Ail;commerciai requirements must me6compliance <br /> N PERMIT Attach(2)sets of Mngineered Plans. <br /> -"'PROPERTY SURVEY.required for all NEW co'nstructi'on. <br /> 13I1�:7TI12�EIE�2l73TtI2t�SG32'III?T�3�'*'�'*'R'''*i��C1�CCY� 122:puC{IS3I1: �IY. . <br /> Ictlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized I <br /> of,over$2500,u Notice of Cornmencement is required. (A/C`upgrades over$7600) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> R.'rHE COUNTE,Rl'PERMITTING (Front of Application Only) <br /> ok;If shingles ( Sewers Service Upgrades A/C Fe'I ces(Plot/Survey/Footage) <br /> nrrveways-Not over Counter if on public'roadways..needs ROW <br /> { <br /> I <br />