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' <br /> ��1���� <br /> ~.. .~.~.�° C�yof�aohVr�\U8P8n`n�/\o�UC8tVO <br /> Building Department . <br /> Date Received Phone Contact for Permitting <br /> 0 ow r's in Owner Phone Number <br /> wrier's Name <br /> Owner's Addressl 17-(a m,_:T�'I r r n m I V, 17-apeon- 3�L Owner Phone Number <br /> -Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple <br /> JOB ADDRESS )I T Cr,�A Ili <br /> SUBDIVISION PARCEL mw <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED wewcomsrn xooAto' �--1 a|GN F--\ F--1 DEMOLISH <br /> [!� |NBTALL [_1 REPAIR <br /> PROPOSED USE [--1 ' oFR F--1 COMM F—�| OTHER <br /> TYPE OF CONSTRUCTION r��r8LOCK F—� FRAME [---1 STEEL <br /> BUILDING SIZE _ <br /> �--�BU|LD|NG <br /> �—� �--\ �—� W.R.E.C. <br /> ELEC�RCAL / P�os��uu�m�msv . . <br /> ��� <br /> �-1p0���� <br /> �—� <br /> =MECM/qNICAL VALUATION OF MECHANICAL|NGTALL8T0N <br /> =GAS ROOFING �—l � SPECIALTY OTHER <br /> �OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER 1 0 1 COMPANY -D, g-� "v- 7 <br /> SIGNATURE REGISTERED _l/ N ~Eftu«xxE^ LILN_J <br /> Address Uvenae# <br /> ELECTRICIAN COMPANY , <br /> SIGNATURE REGISTERED Y N_ ps7EcvxnE^ L_YIN_� <br /> Address J060S License# <br /> ` - <br /> PLUMBER COMPANY <br /> SIGNATURE nsa/nrsnso pEsoonF6^ L�2N�� ~^ <br /> Address Mlofa License# <br /> MECHANICAL <br /> SIGNATURE REGISTERED " L]2-�_� FsecunesN NL� <br /> xdurm, � Lkcenoe# <br /> OTHER <br /> SIGNATURE L�2��_| psecunns^ L�1 LNL��» <br /> /Wdrw, Licenue# <br /> x m 1.1 u u u m w 11 u o m K u x x m m x x x1 m n x x x—k m m x x x m u x x n x x m n x n u u o u n x x n x x u u m x n x n x m x n <br /> RESIDENTIAL , /N�nh;g Plot Plans;;�so�ofB�|dingP�ns;(1)set nfEno� �}4m yFnrms�� PennitfornawomnsbucUon. <br /> Minimum ten(10)working days after submittal date. Roquirednnsite.CmnotrucUonP(ano`8honn*mterP|ano*yGUtFancoinats||od, <br /> Sanitary Fmci8ties81dumpstec Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Atfach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(1O)working days after submittal date. Required ona!te.Construction Plans,Stonnwuter Plans vt Silt Fence installed, <br /> Sanitary Facilities&1du Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets nf Engineered P|ona. <br /> `PROPERTY SURVEY required for all NEW construction. <br /> Directions: - - - - ' - - ' - ' ' - ' ' - ' - ' <br /> Fill out application completely. <br /> Owner @ Contractor sign back of application,notarized <br /> If over$2so0,o Notice ofCommencement is required. (AIo upgrades over$7500) <br /> � Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letterfrnm�owhee authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) � <br /> RemofsKshimqIem sewers Service Upgrades A/C Fonuou(P{oVGuney/Footago) <br /> Driveways-Not over Counter ifon public madvmays..neudoROW <br />