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QtVDf7eohY[hU\s Permit Anp\\CatiOD Fsx-813-780-0021 <br /> ` . Building Department <br /> ' <br /> Date Received <br /> IC <br /> Owner's Name Owner Phone Numl <br /> 3�L Owner Phone Number <br /> -Fee Simple Titleholder Name -s-rl w_ Owner PhPne Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS o6 LOT# <br /> (OBTAINED FROM P ROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE ' SFR 'COMM OTHER <br /> DESCRIPTION u,WORK <br /> BUILDING SIZE <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> �--�E��C�R\CAL AMP �--1 p �-� <br /> ___' . <br /> 0AA Id <br /> q <br /> ����—\PLU rw <br /> �-_� =�KiG �pn~ .�� <br /> � ~ <br /> =mECMANIcAL MECHANICAL INSTALLATION <br /> '[--�GAS 1:2RDOFNG F1 ' SPEC|8�`� | | OTHER7r ' /Soo <br /> F(N\SHEDFLOORELE\A\TONG FLOOD ZONE AREA [__]YES No ' <br /> ="/L"Em C"='=`' <br /> SIGNATURE eco\orsneo L_l/_N_J rEP:c«mRE^ L_Y/NL_| <br /> Address License# <br /> ELECTRICIAN >RLCOMPANY <br /> SIGNATURE nEo/aTsnso L_11�L_] resouRneN L_l7 N_� <br /> Address <br /> PLUMBER � <br /> SIGNATURE '^ <br /> Address <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> �2 Address <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED -.Y1 <br /> ' <br /> Address <br /> u x x 11 1 x x u m 1 u x n m m x x u x x x x `u x u x x-m I x I I K I x u 1 101,10 N 1 1 x 1 x 1 1 1 1 w x x K <br /> RESIDENTIAL Attach Cq Plot Plans; sets of Building Plans;(,I)set of Energy Forms;R'0-W Permit for new construction, ` <br /> Minimum ten(1V)working days after submittal date. Required onsite.Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Pergilt for subdivlsions/large projects <br /> COMMERCIAL Attach(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(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities Q1dumostar.Site Work Permit for all new projects.All commercial requ|m�nantsmuetmoe6com�ianno <br /> SIGN PERMIT /�avh�� �� sof Engineered P|�ns. ' <br /> ~°°°PROPERTY SURVEY required for m\|^NEYVconstruction. - <br /> Fill out application completely. � <br /> Owner&Ounhacior sign back of application,notarized <br /> If over*usun^a Notice qfCommencement is required. (Vc upgrades over$75OO) <br /> � Agent(for the contractor)or Power of me�(for the owner)would bo someone with notarized letter from owner autho in sama <br /> O�ER THE COUNTER PERMITTING (copy ofcunhant�qu(md) <br /> Remofs if shingles Sewers Service Upgrades A/C Fonpes(P|ot/Sumey/Footag' <br /> Orha,aaym-Not over Counter ifnn public madvaym'ooe4aROW <br /> � . <br />