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Fw»81@78O�02� <br /> ' - --_ ultyct \\\sPermitAopUoatioO <br /> Building Department <br /> Date Received <br /> Phone Contact for Permitting <br /> r's m <br /> Owner's Name n c- Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION 0# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED ' wuwoomsTn F7 AIDOIAlJ �--1 SIGN F--7 F--1 DEMOLISH <br /> F—� INSTALL |�| REPAIR <br /> PROPOSBD USE [--� aFR �—1 COMM �--1 OTHER <br /> TYPE OFCONSTRUCTION E2- BLOCK [--\ FRAME F--� STEEL �--1 <br /> DESCRIPTION OF WORK <br /> BUILDING IZE SQ FOOTAGE HEIGHT . <br /> �_]8U|LD\NG VALUATION OF TOTAL CONSTRUCTION <br /> �--\EL��TR|��L AMP �--| PROGREGGENER{�' F—� VY.R.E.C. <br /> ���' <br /> =pLUMBNG <br /> _ <br /> F--l�ECH&Nk�\ MECHANICAL <br /> �--� — VALUATION -� --- <br /> �—�G�S F�� ROOFING [—� � SPECIALTY �--� OTHER <br /> �� <br /> FINISHED FLOOR ELEVATIONS FLOODZONE/\REA F--lYE8 NO ' <br /> - - - - - - - - - - - - <br /> BU|LuER COMPANY <br /> SIGNATURE nsamrsnso [,1l_N_]' psscunRs^ _yiN_� <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE xsa|uTEneo ^ peEcvnnEx — <br /> Address <br /> PLUMBER COMP/NY <br /> SIGNATURE o ReoIorseso Y N 'rsEtunnEx <br /> Address License <br /> MECHANICAL COMPANY <br /> SIGNATURE nsa/arsREo � <br /> Address <br /> OTHER CO�pANY <br /> SIGNATURE nee\srsneo -- <br /> . <br /> Address Uuonoa# <br /> RESIDENTIAL Attach(2)Plot Plans;*(2)sets of Bull ding Plans-,(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum working days after submittal date. Required onsito.Construction Plans,OtonnvaterPlano vlGilt Fence Installed, <br /> Sanitary <br /> COMMERCIAL Atfach(2)complete sets of Building Plans plus oLife Safety Page;(1)set of Ens��r-ms.R-O-W Permit for new 'construction. <br /> Minimum ten(1O)working days after submittal date. Required onaite.Construction Plans,Stormwater P\anavl q\\t Fence Installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirbments'must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. ' <br /> Fill out application completely. <br /> Owner&Conbacin sign back of application,notarized <br /> If over$2aDo^a Notice cfCommencement is required. (AIC upgrades over$75OO) <br /> ~~ /Agent(for the contractor)or Power ofAttom (for <br /> same <br /> OVER THE COUNTER PERMITTING (COPY nf contract required) <br /> Romofsifshingles Sewers Service Upgrades A/C Fences(P|nyBumay/Fuotage) . <br /> Driveways-Not over Counter ifon pub\iomadvays..noada ROW <br /> / <br />