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Date Recelvild <br /> 1� Phone Contact for Permitting <br /> Owner's Nam(I 'I Owner Phone Number 8' 714 -8(ogal <br /> OwneT's Addross Owner Phone Number <br /> Fee 3'Imple Titlehold or Name Owner Phone Number <br /> JOB ADDRE <br /> 88 kom o, __-3 __42 LOT <br /> WORK PROPOSED NEW CONSTR ADWALT SIGN <br /> INSTALL REPAIR DEMOLISH <br /> PROPOSED U13E SFR COMM OTHER <br /> TYPE: OF(:;ON:STRlJc*DCIN [--1 BLOCK �—1 FRAME [---� BTEEL <br /> [5�'l8UIU0N8 <br /> ��� VALUATION OPTOTALCONSTRUCTION <br /> F--l�LE�T��AL AMID SERVICE [--� PROQKIESSENERQY F--1 VKR.E/O. <br /> F---|pLUWB|NG. ` <br /> � -^ <br /> F'--\ VALUATION DF MECHANICAL INSTALLATION. - <br /> ^ <br /> | <br /> F---l8AG �--| ROOFING F--1 SPECIALTY OTHER <br /> UTHGR <br /> `(m|SHED FLOOR ELEVXT8N8 FLOOD ZONE AREA —�--lYE8 NO <br /> | ^- ~ <br /> 713 <br /> it <br /> Address <br /> 1ECJRCk\N COMPANY <br /> /|GN&TUR REGISTERED [.y�l�_] rsscuwnsN 1 <br /> Address � __ ( L|oonoo# <br /> LUm113ER � COMPANY <br /> |GNATUR0 [_ [^y/�4[_] rsscunne^ 1= <br /> ---1 <br /> Address License# [___ ] <br /> |ECHAN/C'AL ' COMPANY E <br /> |GNATUR2 xsG/arsnso �_y!1V_] rsscuaRsx . [ <br /> Address [ _] Linenoo# <br /> THEM COMPANY E <br /> |gNATURE [ � ] REGISTERED [_y/_0__]�nso � psauunns» 7_ 177 <br /> /«]d0000 [ Lioonuo# <br /> ++-Hf+H i1fill! -H+H+/ <br /> ESUDIENT|&[ Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Rermit for now construction. <br /> Minimum ten M0 working days after submittal date, Required unu1hn,Construction Plans,8|ormwater Plans vl Slit Faouuinstalled, <br /> G |ta FadUUem&idumpoh�|�ha�brhPormk�r�ubd\v|o|uno8orAopn�a�o <br /> DMYAERC\&L '(3)complete sets of Building Plans | LKe Safety ( )set.'of-Energy Forms, R-O-WIDenTlItfornewudnuhnu0uu.Minimum ten(110)working daysafter submittal date, Required onsite,Construction Plans,StPrmwater IPlans w/Slit Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance � <br /> GIN PERMIT Attach( )sets o,Engineered P/uno. � <br /> °~°PROPERTY SURVEY required for all NEW construction, <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> lihover$2500,it Notice of Commencement Is required. (A/C upgrades ovor$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> /ER'm COUNTER PERMITTING (Front d Application Only) <br /> `rooft�\fshingles 8uwarx Service Upgrades A/C Fonmm(P|u8Sumoy/Fnoboga) <br /> Driveways-Not over Counter yo�pu�ip[npdwayu.nwedoROVY <br /> 'i- — � - -' <br />