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` <br /> MTM <br /> Owneir's Address[a <br /> Owner Phone blumber <br /> Fee Simple Titlehold er Name Owner Phone Number <br /> Fee,Simple Titleholder Address <br /> JOB ADDRESS i <br /> SUBmIVISkO14 ! PA���L�# <br /> | - (bbnwwuopnompnopsnz,rAXNOTICE) <br /> WORK PROPOSED � moWcoNsTR ADD/AT F--� SIGN F^-� �-- �2��U8H <br /> INSTALL <br /> REPAIR <br /> ---- ---- --- <br /> PROPO$EDU13E ' F--1 8FR �-� COMM F--� OTHER <br /> TYPE OF("'ONSTRU/ [|CIN �--1 BLOCK F-1 FRAME [-'-7 �TEEL F--1 F---------------'---1 <br /> ___ <br /> +_ <br /> BUILDING SIZE act 1:60TAGE HEIGHT <br /> ���BU|U]|N8 <br /> � VALUATION OF TOTAL,CONSTRUCTION <br /> [_��ELEOTK|0,AL AMID SERVICE [--� PRO�KIE8SENERQY r-1 VKR.G.O. <br /> - <br /> [ -�pLU�8|N�� <br /> `--� <br /> F��E�HAN| V��|�OP�E��|��|N8��|�� � � <br /> �-_� �- <br /> | <br /> [-=QAS [--1 ROOFING �-1 SPECIALTY F---1 OTHER <br /> lN|SHEDFL0ORELEVATIONS FLOOD ZONE AREA F-~]YEG NO <br /> WILDER COMPANY <br /> '|GNxJVRI- nso/STEneo <br /> '4dd,aom LIcense# ac <br /> !LECJR|C|AN COMPANY <br /> oGNATUR� � cun�s <br /> AddressL�onon# <br /> LUMBER COMPANY <br /> L_y�_�_�] pss|GNATUR� mes/orcnco cunnc^ <br /> /\dd,amo [ _] LlcenseO � <br /> |ECHAN|C'AL COMPANY <br /> |GNATURE [ _ � nsa/ursnso E/l,yN ~] nREN <br /> Address [ _J License# )THGR COMPANY E __ _ i <br /> |mNA L_y!��_ <br /> TUR� [ � ] neo/e�snso � ] rss��unns^ _�ll�_� <br /> Address License it <br /> ESU)IENTIAL Attach(0 Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;F-O4Y Permit for now construction, <br /> Minimum ten(iO)working days after submittal date. Reguimdonu)bm.CooakuP0unP|ano.8honnwuterPlanouV8ihFenooInutalled' <br /> Sanitary Facilities&I dumpster;Site Work PermIt for subdivislons/large projects <br /> OM0YERCh4L- Attach(3)complete setsof Building P/ iu a-Ub*GmfotyPn '(JUitehof Forms. R.O4VPenn(Qbr_new obnukudbn _ <br /> Minimum ten(10)working days u8ar submittal doto.' Required bhoUo.Cunahu#UonP\ans,8tunnwuterP|anuW/Gflt Pbnuu|ho(al)od, <br /> Sanitary Facilities&1 dumpster.Site VVurkPann|tkxoUnm*pnojndu./0)unmmerc\a\noquimmantsmucdmeotc4mplianuo . <br /> GIN PERMIT Attach sets of Engineered Plans. <br /> ^°"PRDPBRTY SURVEY required for all NEW construction, <br /> Fill out application completely, <br /> Owner&Contractor sign back of application,notarized . <br /> III over$88V$.o Notice uf Commencement|mrequired. (AJC upgrades over$75U0) � <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> /ERTHECOUNTEMP0'IRM|TT|NG (Front d Application Only) <br /> `rmok:(fohhng|u,; Sowers Service Upgrades A/C Poncao<P|oVSuwey/Fnotaga> <br /> Driveways-Not over Counter Mon public modwoyu..need oROW <br />