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Building Department <br /> Date Received rlxoritn '7 <br /> = Phone Contact for Permitting ( <br /> Owner's Name ' mk, tjx�z )nc- Owner Phone Num' ber <br /> Owner's Address I atooi, 7D R_343-� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS <br /> sVBDN0|nN oo# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED mowoomsTn m]o�J�' �--1 G|GN �--! �—� DEMOLISH <br /> �_] INSTALL �_l REPAIR <br /> PROPOSED USE �-� SFR F--� COMM �--� OTHER <br /> TYPE OPCONSTRUCTION �-��' BLOCK F—� FRAME �--1 STEEL <br /> DESCRIPTION OF WORK sircm- to Zi&_ACy__ V—Feol <br /> BUILDING SIZE SQ FOOTAGE <br /> =BU|LD|NG VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTR|CAL AMP SERVICE �--� PROGRE8GENERGY F--1 VY.R.E.C. <br /> =PLUWB|NG <br /> F--lMECM8N|CAL MECHANICAL INSTALLATION - \ \ - <br /> �—�GAS 7l 'ROOFING �-� SPECIALTY OTHER <br /> OTMER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YE8 NO | <br /> BUILDER COMPANY <br /> SIGNATURE nsoISrsnso LY N FEEu»«ub\ L� /N_� <br /> Address I uunso* <br /> ELECTRICIAN Cum,*m, <br /> SIGNATURE nesmrsnso NL1 rEiEouRxE^ I /N_� <br /> Address License# <br /> 5- <br /> PLUMBER COMPANY <br /> SIGNATURE nso/ersneo LY/_N_ psstunns^ <br /> Address License# <br /> MECHANICAL compAm, <br /> SIGNATURE nse/ar�neo ' L_2 /_N | rkovnnE^ " LY N_J <br /> Address License* <br /> OTHER coMP*m, <br /> SIGNATURE mso/ensmso LY/ N_} reocunxE^ L_���L� <br /> Address <br /> xxmuxxxnmxxunnxoxxuxxxxu'xnuox /ponnxnxuuuuu " " xoun " xuu000xu " ox . " " " ° " " " <br /> RESIDENTIAL Attach(2)Plot Planx;'(2)sets 'of Building Plans;(1)set nf Energy Forms;R-OANPermit for new construction, <br /> Minimum ten(1O)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> S Fac <br /> ilities dump�or;Site VYorhPermit for aubdi�sinn�ia,gopn�emo <br /> COMMERCIAL /��oh(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fo rms.F-o4W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,S8onnvater Plans v/Silt Fence installed, <br /> Sanitary Facilities&1dump Work Permitfor all new projects,All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets or Engineered Plans. <br /> °°°°PROpERTY SURVEY required for all NEW construction, ' <br /> ~.=".=. ` - <br /> Fill out application completely. � <br /> Owner&Contractor sign back nf application,notarized <br /> If over$2sVV^a Notice of Commencement imrequired. (AIC upgrades over$75OO) <br /> = Agent(for the contractor)or Power of Attorney(for the owner)would bo someone Withnotarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Ramofs if shingles 8ewmm Service Upgrades A/C Funces(P|ut/Gumey/Footago) <br /> Driveways-Not over Counter ifon public madvmyo'noedoROW <br /> ' <br />