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".=""_U U <br /> v�u [�tvof�aohV[� lt Permit Application Fa�O 3�80�O21 <br /> O� � a�» <br /> Building Department , <br /> ' <br /> Date Received Phone Contact for Permitting <br /> 0 owner's 13c Owner Phone Number <br /> wrier's Name <br /> 3S Owner Phone Number <br /> Owner's Address 72 3S <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> Ki I is <br /> SUBDIVISION JAJ,�n-� 'b(IV-kiZ�AU ARCEL ID# 2 (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> E�' INSTALL REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION E2- BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ FOOTAGE HEIGHT"BUILDING mo VALUATION OF TOTAL CONSTRUCTION <br /> F--�PLU�B\N� <br /> {��__/.�"~~..� <br /> F--��E�HAN\�AL MECHANICAL INSTALLATION <br /> �__^ . <br /> �--�Gxa F7~1 ROOFING F--l � SPECIALTY �---1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE nsoISTEnso LY/ N rEEcu*RE^ LYIN I <br /> Address � e� <br /> H-LEczRICV\N ooMpxmY <br /> SIGNATURE nsomrsnEo pesounnsN L_lINL� <br /> Address License# <br /> :'LUMBER COMPANY <br /> S\mM4JVRs RsGmrsneo L_1�_� \ FsETCunnsx L�LLNL� <br /> Address Unmnno# <br /> *EoHAN/C\L COMPANY <br /> SiowxJVRE osoImTsneo pLcunns^» I 2 NL� <br /> ~_ <br /> Address License# <br /> ]THER COMPANY <br /> SIGNATURE neaansnco LY/_N_] rsscunnsN L�L/N_] <br /> Address Ummse# I cc <br /> x u x x x m m n m u u m m x x x x m m x x x x u`o x x n K 1pn n o u m u x u x x u I u u x u m o x n x I m x x <br /> IES\DENTVu- Attach(2)Plot Plans-,(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(1O)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Slit Fence installed, <br /> Sanitary Facilities&1dumpster;Site Work Permit for subdivisions/large projects <br /> *O8K88ERCV� /�odh(2)complete s�s of Building Plans p�saL��G���Page�(1)ootofEnorgy,F���.F�{�VY Permit for new construction. <br /> Minimum ten(1U)working days after submittal date. Required unoi!a.Construction Plans,Stn P\ansyl Silt Fence installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> iiGNPERM|T Attach p>sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. ' <br /> "=^"".=. ` <br /> Fill out application completely. _ <br /> Owner&Contractor sign back of application,notarized <br /> |f over$zo0V'a Notice pf Commencement isrequired. (A/C upgrades over$7*UV) <br /> " Agent(for the contractor)or Power of Attorne�(for the owner)would be someone with notarized letter from owner authorizing same <br /> uDER THE COUNTER PERMITTING (copy pfcontract requireU) <br /> �mnfs If shingles Sewers Service Upgrades A/C Fences ` <br /> Driveways-Not over Counter ifon public modvayo.needsROW ' <br /> . <br /> ' <br />