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ultyof ZeOhV[hU Rl� R�����2|Gp8[ <br /> An�(���toD / <br /> Building Departmentav-koflto, CV" <br /> Owner's N7ame (im ii n r =w <br /> Owner's Address 33� owner Phone Number <br /> -Fee Simple Titleholder Name f yap_ owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS SL <br /> ' <br /> suBoxnauOm PAnoELnD# <br /> . (OBTAINED <br /> WORK PROPOSED mowcomsrn R AoO/ALT �--� SIGN �-� �-1 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE �--1 SFn �-� Comm [---1 oTHER <br /> TYPE OFCONSTRUCTION r7r~ BLOCK F-� FRAME F---1 STEEL <br /> BUILDING SIZE ' <br /> =BU\LOlNG VALUATION DF TOTAL CONSTRUCTION <br /> [--lELE[Tll|CAL AMP SERVICE �--� PROGREGSENERGY |�| VV.R.E,C. <br /> ' <br /> [--lpLU�o\N� <br /> �--� <br /> ' \ v <br /> �-����HAN)��� ctb MECHANICAL INSTALLATION <br /> ��� <br /> F---\aAG ���' ROOFING |-i SPECIALTY | | OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> ou/uzsR Co�PANY lr�C <br /> SIGNATURE REGISTERED ps�cunee^ L�_L�_] <br /> xddmoo Licenae# <br /> ELECTRICIAN COMPANY . <br /> SIGNATURE `Y!N I rssounnsN LD NLJ <br /> Address License# <br /> PLUMBER > COMPANY <br /> SIGNATURE nea/cnsnso [_`h,��] 'pssouRndx LYI/lN_� �^ <br /> Address License# <br /> MECHANICAL COMPANY P1r0J"5S1Qe_ <br /> Ale <br /> SIGNATURE REGISTERED " �^yllV_1 pseounnEN -1,''y!N_] - <br /> Address � Uvanaa# <br /> OTHER COMPANY <br /> SIGNATURE neaIorenso ��1,�_1 psscunAsN L,(!«_]J <br /> Addmss License# <br /> RESIDENTIAL Attach Oq Plot Plans;p0 sets of Building Plans;(1)set of Energy Forms;R-O-N/Permit for new construction, <br /> Minimum ten(1O)working days after submittal date. Required oxui0o.Construction Plans,8\nnnvat rP\anav/Silt Fence installed, <br /> Sanitary Facilities&I dumpster;Site Work Permit for subdivisionsllarge 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 new 'construction. <br /> Minimum ten(1O)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fad|itioo&1dumpotar.Site Work Permit for all new projects.All commercial requirements must meet compliance ' <br /> SIGN PERMIT Attach(c)sets of Engineered PI ans. <br /> °°°^PROPERTY SURVEY required for all NEW construction. ' <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> n over$2soo'a Notice o,Commencement|arequired. (A/C upgrades over$75VO) . <br /> � <br /> Agent(for the contractor)or Power of Attorne�(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Remofs if shingles 8uwors Service Upgrades A/C Fonmm(Pbt/Sumey/Footoge) <br /> Driveways-Not over Counter ifon public madvayo..naedoROW ' <br /> `. <br /> ' <br />