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city ot Lepnyrnills Hermit Application t-ax-181�4-4(td -UUZ1 <br /> Building Department <br /> Date Received Phone Contact for Permitting to <br /> Ownees Name Z!!6 Owner Phone Number <br /> Owners Address It t d -730 .k OIM4 7 Owner Phone Number <br /> Fee Simple Titleholder Name '2e LC Owner Phone Number L <br /> Fee Simple Titleholder Address 7/0 &"1 4 &J, �6f-M"ml� M 6 9 46�3 7 <br /> JOB ADDRESS LOT# <br /> A �11 6W " <br /> SUBDIVISI�N F PARCEL ID# /0 061 630 <br /> i (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM OTHER rvgfa�Wll <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK =Nywiotls� Por-6m 5CQtaide, kbaM ]�-i'm 6e.me 616ie 1-a I" <br /> BUILDING SIZE S-C SQ FOOTAGE PlOzek) HEIGHT -6 49,6a26-1� <br /> =BUILDING VALUATION OF TOTAL CONSTRUCT <br /> =ELECTRICAL 1$ AMP SERVICE RES W.R.E.C. <br /> =PLUMBING 1$ <br /> [MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> [ GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> BUILDER COMPANY <br /> SIGNATURE (92UL REGISTERED Y/ N FEECURRE!, ' L_ZIN_j <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N _J FEE CURREN <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN L_y LN J <br /> Address —1 License# F— <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED YL/ N FEE CURREN <br /> Address License# F— <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y FEE CURREN <br /> Address License# <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/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for now construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl 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 /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Direction <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$7500) <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 (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plotf8urvey/Footage) <br /> Driveways-Not over Counter if on public roadways-needs ROW <br />