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Date Ftecelvq Phone Contact for Permitting �l3 1 6ct - q6� <br /> x1'sxTxix52'.tS��E21 •�;� � <br /> Owner's Names r OwhOtPhohdz*iu <br /> Ownelr's Address C_-.-7 1 q 10 '1 e-- A i _ Owner Phone hi { ber CI3-3 <br /> r f ._.. <br /> Fee 5impfe 1'Nletltolc(er Name .L �,_ _• ___. Owner Phone Alumberr <br /> Fee Simple Titleholder Address �. <br /> JOB ADDRESS I E?C 3 0 Pn 2 g t�_G7 ZenhR t!5 L 3'3 5^�~JQ LOT <br /> sui3ivislaN A i PhA 1Ii 1jA9e PARCEL tE?#L3 ` <br /> _.. foSTAiNED FROM PROPERTY TAX NOTECL'); <br /> WORK PROPOSED i NEW',CONS I� ADD/ALT C_� SIGN �, DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE C�` SFR. �� c.Omm. C_•,] OTHER [ <br /> 1 a FRAME: STEEL " <br /> TYPE:of c,caNSTR ac rtc N ;C f�► BLocr, , C _ _ C_.� /L.�, C..._.._ _.� <br /> DESCRIPTION Oi-,WORN: !'ePtAC'E i aNiTs S��!`�+'� FL 16bQ3 t �-( tl2pb��� <br /> 3UlLDlNG SIZE _'I _r i i i50 i°OOTAO - i,_,_ _r tiEEft3H1 [ � <br /> u�ts �Ex>"IlIct >rias�a�ztzr>~Eats :rts :�:ri�civaExiux� <br /> vALUATiON of TOTAL;c6NStRU6TiON <br /> [-�E:L.IECTkl('Al. r^� AMP SER1tICE F'ROCCRESS.ENERC)Y,. . C . W.R,Ec:C. <br /> PLiJMF3(Nt�i " <br /> VALUATION 01:MECHANICAL'INSTALLATION- <br /> GAS { ? ROOFING SPECIALTY OTHER <br /> � C C C,� i <br /> INISHED FLOOR ELEVATIONS � FLOt)U ZONE AREA -- YES ' NO <br /> tf t t S I ti I f titl-HtH.. H..t tip t t Ei Fttf t t i Ft+H t t t F t tii t� t i i ttH � t•i t kN-t-t + + t t tttf-!4!t t t hH ht tt t tH t t t t 1 <br /> UILIDER J`=`'n_ COMPANY C`"�aW^E:1 1-:6me, T•e.R '�-- L,t-,�--_,__� <br /> 1GNATURE _�f' rEt'zE cN? Gf?o REGISTERED Y/ N F'EE CURREN Y/r" 1 _ <br /> ,Address j ;Eo_60)t —1$ i��C �:,I ANC� .=� '3z�?�t Llcens�e# �Z 1E6iFy/7 <br /> _EC�1'RICIAiV i � ' C{)MPANY <br /> GRATURIii I ; i REGISTERED ' Y/ N".T FEE CURREN Yi/ <br /> Address t�-._.._.___.. •; Ltcen<�e#' <br /> .0 NI BER COMPANY _ <br /> 3N,ATURE I REGISTERED Y/ N r FEE CURREN <br /> Address ._ _ W �., License# - <br /> :CFt,ANlCAL - �~ COMPANY <br /> 3N,ATURE REGISTERED Y.'/ N FEE CUWEt, Y 7 N <br /> Andress Llcens # <br /> HE:Ft 'COMPANY <br /> 1N,ATURE � REGISTERED Y/ N J FEE CURREN <br /> Address _ _ License# <br /> Hiii t+E+iit+hi-Hi fii t tifi tilt ti t t Hiif..!!H f I!.1 E tt•F•+H-i•t-Ftf H hi-H-4•H+I 11 111 ii•t hFi t1-Ht!tt t P•H+H4 ttttti t t-ti-Ft i tii till i-t44.I•I+I-I1 t1.t t t+I <br /> SIDIENTIAL Attach(2)Plot Plans;(2):sets of Building Plans;(1)set of Energy Forms;R-O-W.Permit foe new construction, <br /> Minimum ten(10)workin j days after submittal date. Required onslte,Construction Plans,Stormwater Plans wi Siit Fence installed, <br /> Sanitary Facilities&1 du�npster;Slte Work Permit for subdivlslons/large projects <br /> MfdERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)Iset of EEnergy F'orms'dR-O-W Permit for new.cbnstruction. <br /> Mlinimum ten(10)working days a`fterssubmittai dato. Required onsite,Construction Plans Stormwater Plans w/Sllt Pence Installed;- <br /> >anitary Facilities&1 duinpster.Slte Work Permit forall how projects.AlLcommercial requlrements must meetcompliance <br /> N PERMIT Attach(2)sets of Englneered Plus s. <br /> "'''`PROPERTY SURVEY.required for all NEW construction. <br /> 23X==3SCE3�tSt=rM �77.i= ��IRr3z=I123 33I:R �IXIt�t: XLLI. <br /> ticta,tins: � a , <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized s <br /> !I(over$.50i),EE Notice of Commencement is required. (A/C upgrades over$7500) 1" <br /> Agent(for the con Itractor)or Power of Attorney(for the owner)would be someone with notarized letter frorn owner authorizing same <br /> :R.'rHE COUNTER PI:ERMITTING (Front of Application Only) <br /> ,o'fs If Shingles. {i Sewers Service Upgraades A/C Fences(Plot/Survey/Footage) <br /> Oriveways-Mot over Counter if on pub lic;roedways:.n6eds:ROW.- <br /> i <br />