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.�^. ~~- - � DfZephV[hUls Permit Application F�����2oO 1 <br /> U4 �- " ^7//�' //��»�o-� Building Department <br /> ' - <br /> Date Received hone Contact for Permitting <br /> Ali <br /> Owner's Nam. Owner Phone Number <br /> Owner'sAddressl Iva Owner Phone Number <br /> -Fee Simple Titleholder Name I I Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Va5±isr <br /> mVBonoe\oN F31 pARCELUD# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED wewcomsm F7 mDowoLT F--� D\GN [--1 [--1 DEMOLISH <br /> E5 INSTALL [ l REPAIR <br /> PROPOSED USE = . eBR F-� COMM F--� OTHER <br /> TYPE OFCONSTRUCTION � BLOCK �—) FRAME F---� STEELBUILDING SIZE SQFOOTAGE�11 W HEIGHT <br /> ' <br /> F--lBU|Lo|NG ' <br /> �—� VALUATION OF TOTAL CONSTRUCTION <br /> �--lELECTR|{AL AMP SERVICE F--1 PRO8REGGENERGY F—� VY.R-E.C. <br /> ____ <br /> =PLU| iNG <br /> \ <br /> =MECH8Nk:AL <br /> ' $ C�5 VALUATION OF MECHANICAL INSTALLATION <br /> =GAS . F—Y ROoRNm [—1 SPECIALTY | | OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YEa NO <br /> BUILDER COMPANY <br /> SIGNATURE mea/STEnso L_2 /_N_J pssc«nne^ L_l/NL� <br /> Address Uoonaa# <br /> ELECTRICIAN COMPANY <br /> L�S�8CA <br /> SIGNATURE y1,lN_l - peEoUnnEN [_y),N_] <br /> Address Li # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED [Y/_N ] 'rsscuwRdx [f8N � <br /> Address License# <br /> MECHANICAL <br /> SIGNATURE ' �-T[1N_] rsEnumns^ -t^`/!N_] <br /> e2 <br /> Address ) License# <br /> OTHER COMPANY <br /> SIGNATURE nse/ursnso [_y/_�_l pssounRs^ Ly!N__LJ <br /> ' <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(1D)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Foci)\tiea&1dumpstar;Site Work Permit for subdivisions/large projects ' <br /> COMMERCIAL Atfauh(2)complete sets of Building Plans plus oLife Safety Page;(1)set of Energy Forms.F-O-m/Permit for new 'conatructimn. <br /> Minimum ten(1U)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1dumpste�Site Work Penn�for all new pn�e� ���� oummen�o|mq�m6na�smuetmo�guompUunue <br /> SIGN PERMIT A#auh(2)o�sofEngineeredP|�no. <br /> ^**°PROPERTY SURVEY required for all NEW construction, <br /> Directions- <br /> FiU out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over*csou.a Notice of Commencement is rvqu|mu' (xC upgrades over*7500) <br /> Agent(for the contractor)or Power of Attorne�(for the owner)would be someone with notadzed letter from owner authori7ing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Rnmnfs If shingles Govem Service Upgrades A/C Fencas(PlobSumey/Fnotaga) <br /> Driveways-Not over Counter if on public madvaya,naedo ROW <br /> ' <br />