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w- uv-wc� VILy VI LC)JI lyl I IIIIJ r-W 11111.J-%JJIJ11t;d LIUi I 1 qA-V 90-1 OW-UV41 <br /> Building Department <br /> )ate.Receive1.d . R" /�t111� Phone Contactfor Permitting <br /> I-t-I T I77-� /� <br /> )wneVs.Name •j'L I+(- 'I mt_ CU"Ivy a.n Owner Phone Number I�j;:q:�l.�:^5fI5 <br /> m-2 S, f=a.IlcenburGi .� �JerJie;,t� <br /> ).wner's Address J Owner Phone Number <br /> �ee Simple Titleholder Name / Owner Phone Number <br /> 'ee Simple Titleholder Address ! <br /> IOB ADDRESS :LOT# <br /> WBDIVISION DW D �S(iD, PARCEL ID#" <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NORK PROPOSED NEW CONSTR ADD/ALT SIGN Q Q, DEMOLISH <br /> Fq <br /> .INSTALL REPAIR <br /> REPAIR <br /> IROPOSED USE 0 SFR <br /> I] COMM OTHER" <br /> TYPE OF CONSTRUCTION '[ '1"BLOCK . (�E] FRAME STEEL [� <br /> )ESCRIPTION OF WORK... "NJ Lon.s 1/ uG n 16: G/ <br /> WILDING SIZE SQ FOOTAGE HEIGHT <br /> =BUILDING $ ! f VALUATION OF TOTAL CONSTRUCTION <br /> J �v" J <br /> =ELECTRICAL $ / J� AMP SERVICE PRROOGRESS ENEERGY Q W.R.E.C. <br /> =PLUMBING <br /> =MECHANICAL $ / VALUATION OF MECHANICAL INSTALLATION. R�^ <br /> 1 . " Lle <br /> =GAS ROOFING 0 SPECIALTY OTHER 4f <br /> =1NISHED FLOOR ELEVATIONS P FLOOD ZONE AREA =YES NO <br /> 3UILDER COMPANY G�Lfe C 79MP GLL <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address r'0��� /i I�eNrez�� :3 License#: <br /> ELECTRICIAN COMPANY <br /> 31GNATURE" REGISTERED Y/ N FEE CURREN LILN <br /> St <br /> Address !" l� . License.# �.��37.L�J <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address . 313�j)/ 3 GJr/a'cx��F�378 J License#: C,/1 e/+�a Ta -�. . <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N" <br /> f{/3 i7 Address l� R SLy1,�l� 3 �(� License# �A <br /> ld <br /> DTHER COMPANY i� Wi� W a_ <br /> SIGNATURE" AQ)_ REGISTERED Y/ N FEE CURREN Y/N <br /> Address �Ig31/J/7//n"Dr ow ,97 /d /f-il 3 License# <br /> 1'" 11 111 ,11 11 11-! 11 i 1 1'1 I i l 1 f 1 1 1 i 1 1 1 1 1 hJ "1 11 1 1 1:1 11 1 I.i l 1 i i"� 1 I 1 1 Il l l i e 1-1.:1;;1 i. <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/Silt 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 w/Silt Fence installed; <br /> Sanitary Facilities&1 dumpster.-Site Work Permit for all 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 /> - - - - - - - - - - - - - - - <br /> Directions: <br /> Fill 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 />