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Ully OT Gepnyrnins rermit Kpp ication r ax-o ts-itsu-Vucl <br /> Building Department <br /> late Received Phone Contact for Permitting p ) q' <br /> I-I-IFF-9-lam-1- -- <br /> )wner's Name P� �t Ito ni C'CU )G�.l1 c, >✓L G ET <br /> Owner Phone Number �j-"1�� •✓ hj <br /> )wner's Address 21_G-Z S. Fa'Ielibt. fa �{/ Vt f di" L Owner Phone Number <br /> 'ee Simple Titleholder Name F / A Owner Phone Number <br /> -'ee Simple Titleholder Address I A <br /> IOB ADDRESS <br /> IUBDIVISION PARCELID# Va- ,Z4,1-00060 (J <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> VORK PROPOSED M NEW CONSTR R <br /> ADD/ALT SIGN Q = DEMOLISH <br /> INSTALL REPAIR <br /> IROPOSED USE Q SFR = COMM OTHER <br /> YPE OF CONSTRUCTION }}'BLOCK = FRAME STEEL = <br /> )ESCRIPTION OF WORK. lZGIJ �D115�^uG�1 t�YJ S�n �� �%VJ/ <br /> I UILDING SIZE l I SQ FOOTAGE -3 I HEIGHT l— <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE Q� P/R-OGRESS ENEERGY 0 W.R.E.C. <br /> =PLUMBING $ J , <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ' i^ <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> =1NISHED FLOOR ELEVATIONS y'/ _p FLOOD ZONE AREA [ YES NO <br /> 3UILDER COMPANY U�Lle 6 PM'/''d tLL <br /> SIGNATURE REGISTERED Y/ N__J FEE CURREN Y//N_ <br /> Address , f 3 License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N_J FEE CURREN/J Y/N <br /> �}' ! EN <br /> h l� / �� ` License# G C,f 3�3��5 <br /> Address p f <br /> PLUMBERJy I COMPANY v Dom <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address 313��"� 3 (/ /�FG3`P License# e l pia 7a_7 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N-1 FEE CURREN I Y/N <br /> Rl3/7Gr► ATJI R 1,Address License# 3 2-0 <br /> . <br /> OTHER COMPANY L]�L&1'4 /��c���Cl- <br /> SIGNATURE 'I <br /> REGISTERED Y/ N FEE CURREN Y/N <br /> Address 1�9311Jvvin o. G/7` /SIT "i��i 37 License# L/3��g33 <br /> 11111111111 ! l1111lIIl1lillll111111111l111111l1111111"111111111111111 <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(10)working days after submittal date. Required onsite,Construction Plans,Stormwa ter Plans wl Silt Fence installed, <br /> Sanitary Facilities&1 durripster;Site Work Permit for subdivisions/large 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(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for-all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> . . . . , . . . . . . . . . . . . . . . . . . . . . . . ._. . . . . . . . . . . . . <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over.$7500) <br /> *" Agent.(for the contractor)or Power of Attorney(for the owner)would be someone with notarized 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/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />