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Building Department <br /> ate Received ' Phone Contact for Permitting ( �-- <br /> -a ++ll <br /> w t't, <br /> ner's Name t,j iC l'tv(1'1 C aU m xt o o L-L C-, Owner Phone Number <br /> wneftAddress c(Az S, Falk(nbul J, iV��r1f�U� l Owner Phone Number <br /> :d Simple Titleholder Name 0A Owner Phone Number <br /> ;e Simple Titleholder Address !A <br /> JB ADDRESS 2S� �l/�D S 4f �7 /�J LOT# <br /> UBDIVISION VIN )�Sy p PARCEL ID# J) -; U/ o(,/ -0 //0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE)' <br /> IORK PROPOSED a NEW CONSTR R ADD/ALT SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> ROPOSED USE ® SFR. F--J COMM OTHER <br /> YPE OF CONSTRUCTION BLOCK Q FRAME STEEL. _ <br /> ESCRIPTION OF WORK <br /> UILDING SIZE SQ FOOTAGE ; y HEIGHT a e!J'' <br /> =BUILDING $ f 1.I li� . VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE Q;�P/R-OGRESS ENEERGY Q W.R.E.C. <br /> lit L "f-"V-� L nG�G�L <br /> : .=PLUMBING <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING Q SPECIALTY = OTHER <br /> 'INISHED FLOOR ELEVATIONS / J FLOOD ZONE AREA DYES NO <br /> i <br /> 3UILDER COMPANY 6�� � !°v�► ►C. C�NL�/i/J ` LLL <br /> 31GNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address IO�iRS• nl r ! /�/e�lR, License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE, y��REGISTERED Y/ N FEE CURREN Y!N <br /> Address f3 Z- l7 J� 101 V4� dlyf�-i ` License# EC 13 00---�-7 I fJ <br /> PLUM13ER COMPANY <br /> SIGNATURE I ,/REGISTERED YIN FEE CURREK Yr/fN <br /> Address �G 3 )II IA) �✓L�7.$5� License# �/a 7a 7-7 <br /> MECHANICAL COMPANY flUl7DS AY <br /> SIGNATURE REGISTERED YIN FEE CURREN Y 1 N <br /> R/3 i7Gn try 1 A7lf, I,FL 3 CP( <br /> Address v License# 3 2D <br /> OTHER COMPANY u 61 Pc0eG'/�y� <br /> aG <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N . <br /> Address J-�rvin l�r eel Off` %cl1 "iFL,3 License# C �/?-Z 993 <br /> A•B ➢ ➢ 1a .aA1a11a11 ➢ a ➢ AAAA0111911A0 ➢ Ag aAalaaaII100BIIa ➢ ➢ 011151a10aIUa18 <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 subdivisionsllarge 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 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 /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> df over$2600,a Notice of Commencement is required. (A/C upgrades over$7600) <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 />