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-_ '__ Llny oT /—ephvrhU|s Permit Application Fax-8 3-780-0021 <br /> . , Building DepartmentDate Received Phone Contact for Permitting <br /> Owner's Name Am �nc Owner Phone Number <br /> Owner's Addressi vzjp e co Pn'DK,7armpA 3 3� owner Phone Number <br /> -Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> Suaon/ISuzN pAaCELuD# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED F wawoomSTn F7 *PDIAlT F---| G\GN �—1 [--| DEMOLISH <br /> | | INSTALL F_1 REPAIR <br /> PROPOSED USE F--1 SFR �-1 COMM [---� OTHER <br /> TYPE OF CONSTRUCTION ' BLOCK [—� FRAME F--� STEEL <br /> ----'---- SQ FOOTAGE HEIGHT ' <br /> BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> F--1 PROGREG��NERGY [—�l VYRE <br /> F—�\ELE�TR|�AL AMP SERVICE � � � . .0. <br /> =PLUMB!NG Is F--l�E�HAN|�A� MECHANICAL — <br /> `--^ ''--���-� - --- <br /> �--)GAS '--�' ROOFING <br /> �—� � GPEo|8LTY �---1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA F--lYE8 NO ` <br /> COMPANY <br /> SIGNATURE F REGISTERED <br /> SIGNATURE �/F.> REGISTERED Y1 N FEE CORREN Y/N I <br /> PLUMBER > COMPANY <br /> SIGNATURE nso/Srsnso LY/_N_ 'Fesounn91, LYl NL_| ~^ <br /> Address License* <br /> MECHANICAL <br /> SIGNATURE REGISTERED , L_�1�4 rsEcunnsx [�1��_� <br /> Address ) License# <br /> OTHER oompAmr <br /> SIGNATURE nso/oTEnso L_l/_N_ reeounns^ L_yLN__�J <br /> ' <br /> Address Uoonao# <br /> RESIDENTIAL Attach(4 Plot Plano sets of Building Plans;(1)set nf Energy Forms;R-O-WPonnit 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&Idumpster;Site Work Permit for subdivia\onshargeprojects <br /> COMMERCIAL Atfach(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 Facilities&I dumoster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets ofEngineered Plans. <br /> ""PRDPER[Y SURVEY required for all NEW construction. ' <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> V over$2soV'a Notice uf Commencement|srequired. (AIC upgrades over$75V0) <br /> ~° <br /> Agent(for the contractor)or Power offdt6mu�(for the owner)would bo someone Withnotarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy nfcontract required) <br /> Ramofs if shingles Snvmro Service Upgrades A/C Fenuoo(P!n#Oumey/Footage) ^ ` <br /> : <br /> Driveways-Not over Counter ifon public madvayo..noodoROW . ` <br /> ' <br /> ` - <br />