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813-7W-0020 City Of ZFiElflo"t1IIS Penihk ApIIC3tlon Fax-913780-0021 <br /> . Bttlid'utg DeparmeM <br /> Date Received <br /> Own�"sNamre' R Owne'Ora nm Worm" <br /> p,, F7 <br /> -�., Fee SEmpie'f[NdMotder l�amc- .Otrrner i�wrte Nirri�ier F - '' - <br /> Fee Sinole 7ftlefi�l&r Address' <br /> .IOBADDREss <br /> PARCEL IDf ai / ©3a4 ODD' <br /> ._Wr� zAX <br /> WORIL PROPOSED e NEW CortsTR � ,omALT . <br /> C] SIGN DEMOLISH <br /> lNSTAtt oREPAIR <br /> PROPOSED USE Q SFR 0 COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME =1 STEEL Q - <br /> DESCRIP`rM 00 WORK-[ 5, <br /> BUILIKNG saE ( 1 SQ FOOTAGE= HEIGHT - <br /> QBUILDING ' VALUATIONOF TOTAL CONSTRUCnON' <br /> =E'LECTRICAL I$ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING 5 � <br /> MECHANICAL z°' VALUATION OF MECHANICAL INSTALLATION <br /> =CAS Q ROOFING Q SPECIALTY C� OTHER <br /> FINISHED i 0011 ELEVATIONS �� FLOOD ZONE AREA =YES NO <br /> BWLDER COMPANY <br /> SIGNATURE MGMYSeD. YIN FEE CURREI. Y I N <br /> Addtess <br /> Llaense# - <br /> ELECTRICIAN COMPANY <br /> S)NATURE REGISTERED I Y 1 N FEE CUMF1. Y I N <br /> Address L cwm#1777 <br /> PWMBER COMPANY <br /> SIGNATURE ttEGtsrERmI Y 1 N. FEE cuttne. Y/N- <br /> Add,ass <br /> y� <br /> MECHANICAL COMPANY jv�,1TJ#9`S QAA _0 <br /> SIGNATURE REGISfEM - _, Yl N. FEE_CU.RRB YlN <br /> Address !f Z I ✓� U qr,;e# vJ� <br /> OMER i COMPANY <br /> SIGNATURE REGISTERED F Yd N FEE CUfft Et - <br /> I • <br /> Addiess. License# <br /> 1 ��, �•� �.�.�.�,1.� l 1 1 1 1 1:ft,� �.1 1 1 1.1-� f i l l l,1 1 1'1 1 1 1 1 1'I I I 1 1 1 Ul 1 11 1 1 1 1 1 <br /> RESIDENTIAL Attach(2)FWb Plans;(2)sets of BWc1irg Puns:(1)set'at FJtcr}Br Farms;R-O-W P.. for new acrtstrudiottr-' <br /> � tuTnimum ten{10}vitiTklttg days alter si16mltlriai tiate;'itegitkad aTtsite,Ooirstrtii�aii Pians;`Stmltlwa#er Ptaris wJ St'It Fence irsstaiied, <br /> Sanitary FacWW s&1 dunapstw Site Work Pamdt for sab6vlmor laras projects <br /> CMQU RCIAI. Attardt(2)aarTtplata NO of Bi&f?p Flame ptua a We Barely Fmw,(1)mt of Enorpy Forms.R-O-W Permit for new=nsWLKr t. <br /> M6dmm tet(10)wat"*,"S ow. dMe.Required-WdW,Cahn Ptalm,SW mwxater PLans wl Sift Fm=kmNled, <br /> Sartlfary Facilities&1 d opsW Site Wort Pond For aD new prof eats.Aft ownmereia]ttlgUlr mw is mast most compikatce <br /> SIGN PERMIT Attach(2).sets of a4ftleered Pfau.'. <br /> "TROPSM SURVEY required for a9 NEW=mbuc ion. <br /> Dirmcdom <br /> FU out appiicaticm cornptetety. <br /> Owner&Contractor sit ba*of WMUcWm notarized <br /> tf over$2500,a NO**of Conanertean d 1=ragtited. (XC UP9rades Ova 4175M) <br /> •e. " Agent(for ttre corttr or Power ofAtlatriep(far the owner).w xk be someone wah notarized letterfrom owner aUtlto b"same <br /> OVER THE COUNTER PERMrrf NG_' (copy of regUbw` . <br /> Remals if sWngles: Sewers . Service Upgrades'A/C'- 'Fences(PiatiScutraylFootage) <br /> Dr"mys Not m Counter if art pulv'rc roadway..rids ROW <br /> i <br />