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�a�813�8V�O21 <br /> ' '--' Ll�/ OT�Sphvrh\U8 \�e[�|�/\op�Ca�OO <br /> Building DepartmentDate Received Phone contact for Permitting I r Ir-T . . . . <br /> Owner's Name n c owner Phone Number C <br /> Owner's Address e cam Owner Phone Number <br /> me Owner Phone Number <br /> Fee Simple Titleholder Na <br /> Fee Simple Titleholder Address <br /> S4 LOT <br /> JOB ADDRESS _V J-,- <br /> ouoommnOm PARCEL 1,5# <br /> . <br /> OBTAiNED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED mawcowrm xoD�lT oEMOUaH <br /> | | INSTALL E REPAIR ------- � <br /> Pm]PoaEDUSE �--1 aFR �—1 COMM [---1 OTHsR <br /> TYPE OF CONSTRUCTION BLOCK F—� FRAME �--� STEEL F—| <br /> DESCRIPTION OF WORK I-)ecl 7. A0 <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> =BUILDING VALUATION OF TO TRUCTION <br /> _--~/ �~ 81� — <br /> �--l��G ��� ROOFING F—� SPECIALTY OTHER OT8ER � � ^ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [--|YEG NO ° <br /> BUILDER COMPANY t"In lr�C <br /> SIGNATUREREGISTEREDL��� ~��u«E^ L�N� <br /> 0 <br /> Address Uuenvo# I Cs Co scrb <br /> ELECTRICIAN ooMpxmY <br /> SIGNATURE neaISTEneo L_l l FEEounRsa L��N_J <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE nsG/STEnso L_Y1_N_J 'pEeouRnsx LYIlN_� ^^ <br /> Address License# <br /> MEcHA N|oAL COMPANY <br /> SIGNATURE , L-(/'N FEEcuRnsN [��� <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED LY/ N I FEecunRE^ LI/NL� <br /> ' <br /> Address License# <br /> xoxxxnxxxuunnnnnnn � xxmx`nxuwx �� xmmxuxum � mxxuunnxKnmmnuxxUxxxxmxxxxmv <br /> -RESIDENTIAL Attach;4 Plot Plans;pq 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 w/Slit Fence installed, <br /> Sanitary Facilities&I dumpster;Site Work Permit for subdivisions/large projects 1 <br /> COMMERCIAL Attach(2)complete sets uf 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 Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirerents must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered P|�ans. <br /> ^°°^P0OPERTY SURVEY required for ail NEW construction. ' <br /> Fill out app|\catinncompletely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$oso0'a Notice of Commencement|arequired. (AIc upgrades over$75VV) <br /> � Agen (�rthe con�adohor Power ufA�oms�Ubr the owmo0wm�dbo someone vWthnNh� zed|o�ar� au <br /> thorizing <br /> OVER THECOUNTER PERMITTING (copy of contract required) <br /> Remofsifshingles Sewers Service Upgrades A/C Fences(P|oV8umey/Foutyge) <br /> Driveways-Not over Counter ifon public madwayo..neednROW <br /> ` ' <br />