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� <br /> ������� <br /> ".�' City of \� PemO�Ao�\��oO <br /> / Building Department <br /> y / <br /> Date Received Phone Contact for Permitting 0!�M <br /> Owner's Name Owner Phone Number --J% <br /> Owner's Address J_JU.00�_,_ke_\CCbM Owner Phone Number <br /> Fee Simple Titleholder Name I -\,:�O",Q Owner Phone Number <br /> Fee Simple Titleholder Address <br /> (OBTAINED FROM PROPERT\f TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> Ef INSTALL REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION E:2— BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK ,rqv- sa <br /> * <br /> �5�BUILDING SIZE ' <br /> =ELECTFUo8L AMP SERVICE �--� pROGREaaENERGY �—� YKR.E{� <br /> =pLUM8)NG <br /> �—l�E���� � <br /> ^__� <br /> =GAS ��� ROOFING �—l � SPECIALTY F---1 OTMER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YEB NO <br /> aV'LoEm COMPANY <br /> SIGNATURE nsa/aTsnso L���L_| 'EEcu««E^ L-Y/NL� <br /> Address License* <br /> ELECTRICIAN CoMpxm, <br /> SIGNATURE REGISTERED pEE,conREx LY/NLJ <br /> Address License# <br /> ,LUMBER COMPANY <br /> 3|mNATURs nsu/ssnED LY/ N FEsnunREx L—YINU <br /> Address License# <br /> wECHxN\oAL ooMPmvr <br /> MomxJVRE F nsamnsnso ` L��_�_� FitEounesNv L� 2N_� <br /> Address License# <br /> )THER COMPANY <br /> ;ioN4JVRE n LYLN I FEsounREN Ll/NL] <br /> Address Lconao# <br /> ZES|DENT!AL 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&1dumpoter Site Work Permit for subdivisions/large projects <br /> ,OKKKKERCU4L ftioohp sets U�plus Page;(1)set nfEomrg s <br /> �FonnR,[uWPnnnitforne*conntroction. <br /> Minimum ten(10)working days after submittal date. Required onsita.Construction Plans,Gtunmvwata Plans yW Silt Fence\nstallud. <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> UGNPERM/T Attach p>sets pf Engineered Plans. <br /> ~°**PROPERr/SURVEY required for all NEW construction. ' <br /> ftections- <br /> Fill out application completely, <br /> Owner&Contractor sign back nfapp|\ootinn.notarized <br /> If over*osno'o Notice pf Commencement iorequired. (AC upgrades over$750V) <br /> " Agent(for the contractor)or Power nfAttorney(for the owner)would ba someone with notarized letter from owner authorizing same <br /> x8ER THE COUNTER PERMITTING (copy p[contract required) <br /> mmufs|fshingles 8avmm Service Upgrades 8K} Fnn000(P!ut/8umey/Footago) <br /> Driveways-Not over Counter Kon public modvayo..needoROW <br /> ' <br /> ` <br />