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Building Department <br /> Data Received Phone Contact for Permitting )3 <br /> I <br /> I A§'� —003 ngle .. . . . . . . . a . . . " . . . . . . <br /> Owners Name DAN16WX 14L)EE&ANJ Owner Phone Number <br /> ownies Address 5% 9 r'o gr Owner Phone Number <br /> tt- <br /> Fee Simple Titleholder flarms Owner Phone Number <br /> Fee Simple Titleholder Address F- <br /> JOB ADDRESS Rq-jo 18-r.4 ,Sj- <br /> .176pNqPHt1Af, rt 3j"qj LOTO <br /> SUBDIVISION <br /> (OBTAINED FROM MWIRMN TAX Nff=4 <br /> WORK PROPOSED R NEW OON70 r__7/AODIALT V 1 SIGN r7 0DEMOLISH <br /> INSTA <br /> LL REPAIR <br /> PROPOSED USE Q SFR M I COMM Q OTHER I <br /> TYPE OF CONSTRUCTION Q BLOCK El , FRAME Q STEEL = I <br /> DESCRUMON OF WORK 1114ST-A1,109MAJ OF OZ66P NiQUAIM6 Pkioiwm-mm —w7A—W�AA)6Z, 9 L(S r97,-f <br /> BUIL13ING SIZE SO FOOTAGE HEIGHT <br /> �✓ . . . . . . . . . . . . . . ... . . . <br /> L. . . .. . . . .. . . .. . . . <br /> L13ING j$qj2-q0-VV ! VALUATION OF TOTAL CONSTRUCTION <br /> ':2rELECTRJCAL ISPS,200 AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUM131kc; i$ 1 1 �� <br /> r7MCCHANICAL is VALUATIONI OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO P(V <br /> ER BUILD COMPANY 1t1-rVfAJr <br /> BUILDER <br /> -S <br /> SIGNTUATUREEZ RmsrEREo I Y/ N I FeacuRREN I Y/N <br /> AdareasIST 60 W. ►1NIV AYE TP14 PA License#� 061 Ll 6 <br /> =01 <br /> c FV-rVrN-r 1�(31.14QR bg: Q 85,q <br /> ELECMCIM ReM am PANY I YIN I FEECURR8� I YIN I SIGNATURE <br /> Add. U.# 1,9 7q�() <br /> PLUMBER COMPANY = <br /> SIGNATURE REGSTERED YIN I Fimcrui;tman Ljj N_j <br /> Address License N <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I YIN I FEE CURPZN I Y/N I <br /> Address U.# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I YIN I FEECumuaP L_XLN J <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plamx.(2)sets of Building Plans;(1)set of Energy Forms-,R-O-W Permit for new cons"d-, <br /> Mlhimumi ten(10)worldng days after submitial-date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&I dumpster,Site Work Permit for subdivislonsfiarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus ai Ufa Safety Page.(1)set of Energy Forms.R-O-W Pernfitfornew construction. <br /> Minimum ten(10)worldng days after submtft data. Required onsits,Construction Plans,Stomwrftr Plans w/Slit Fence Installed, <br /> Sanitary Facilities&I clumpster.Site Work Permit for all new projects.Ali commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. i <br /> —PROPERTY SURVEY required for all NEW construction. <br /> . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> 04."Mo cat I t.Ir". <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement Is required. (AIC upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authortdng same <br /> OVER THE COUNTER PERM(MNG - (copy of contract required) <br /> Rerooft if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Ofivergrays-Not over Counter if on public roadways-needs ROW <br /> -e <br />