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Building Department <br /> Date Received Phone Contact for Permitting <br /> an <br /> Ow er <br /> Ow er Phone Number <br /> Owner's Name �nc <br /> Fee Simple Titleholder Name <�-n w Ow er Phone Number <br /> Fee Simple Titleholder-Address <br /> JOB ADDRESS cAe r, Kr_�cyyi IP I am.?:,e0VW lrvfi 111II—J R -S-3"1. LOT# � %/J � <br /> J(OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRR ADD/ALT SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION <br /> ^ BLOCKFRAMETEELDESCRIPTION OF WORK -7 <br /> BUILDING SIZE=BUILDING VALUATION OF TOTAL CON CTION <br /> =GAS ROOFING SPECIALTY THEIR <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER IPANY <br /> SIGNATURE I <br /> ,R _CCJRREN L �N <br /> SIGNATURE REGISTERED FE�E <br /> Address License# [EE 0 03-113- <br /> PLUMBER <br /> SIGNATURE REGISTERED FEE CUkRdf, L__YLN__j <br /> SIGNATURE E REGISTERED FEE CURREN —t��/N <br /> � <br /> OTHER COMPANY <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms',R-b-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Consi',ruction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&I dumpster;Site Work Permit for subdivisionsllarge pro,acts <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set o Energy Forms,R-O-W Permit for new 'construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Cons ruction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All c mmercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> �**PROPERTY SURVEY required for all NEW construction. <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone With nota!zed letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footag <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> � <br />