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�wn.n y +...Lra{uni?IR <br /> Ite Received <br /> Phone contact for Permittingj� } a _ <br /> -- <br /> } <br /> lvner's Name it.�fiC �` 11'1 C Gi;'M )G(.11 L-�G Owner Phone Number <br /> aner's Address 4(t6: ' �(2.j�CG'II Ji IiG` kardle, I <br /> l WA <br /> Owner Phone Number <br /> :e Simple Titleholder Name Owner phone Number <br /> !e Simple Titleholder_Address 1 A <br /> DB ADDRESS L. 5�� LOT# <br /> JSDIVISiON aks 0 U� PARCEL ID# & - —4/- <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> ORK PROPOSED e NEW CONSTR 8 ADD/ALT � SiGN � � DEMOLISH <br /> INSTALL REPAIR <br /> 2OPOSED USE 0 SFR Q COMM [�� OTHER <br /> (PE OF CONSTRUCTION BLOCK FRAME STEEL <br /> ESCRIPTION OF WORK <br /> UILDING SIZE :el:I ~F SQ FOOTAGE yl"7 <br /> / ____�.___ HEIGHT <br /> =BUILDING. $ /�j --�� <br /> VALUATION OF TOTAL CONSTRUCTION 71, <br /> =ELECTRICAL $ „r, AMP SERVICE PROGRESS ENERGY ® W.R.E.C. <br /> =PLUMBING $ <br /> ice;oo <br /> =MECHANICAL oo VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY OTHER <br /> INISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NOdim 4EAff <br /> WILDER COMPANY <br /> tGNATURE REGISTERED Y! N FEECURREEAp, YIN <br /> Address <br /> �lJ���jS. � License# (./J�( aQ� <br /> iLECTRICiAM COMPANY <br /> >IGNATURE REGISTERED LILNL FEE CURRER <br /> Address c 1 /7 lGI "�/YGTj Q/y G� L 6/ �] <br /> Llcense# F �( `/ <br /> SLUMBER COMPANY <br /> 311314ATURE REGISTERED YIN FEE CURRER Y!N <br /> Address 313,� 7d—&eWi,F4 34795 License <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRER Y 1 N <br /> Address Fatll, daGy1rFG 3c7lP11i7 License# F ( <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURRER Y 1 N <br /> Address l�ru/n IJr 2141 G/?� /G/7G��I�Gr 3 License# 1 -�'`'` 3g <br /> UAAAA "U .UUUUABAIIAAUAAUIIA -AUAAUUUUAAiI99aU10aa Ulu UAA.UUUAAAAAAUAA DRUB UUUA <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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/Slit Fence installed; <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/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 wl Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for ail new projects.All commercial requirements must meet compliance <br /> SiGN PERMIT Attach(2)sets of Engineered Plans. <br /> - PROPERTY SURVEY required for all NEW construction. <br /> Directions: _ <br /> Fitt out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) . <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers .Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> ff� . <br />