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813 /SU1UUZU L.Ily UI LC)JIIyr 1 GI II Ill r.rt,il.....“..s, Building Department (4 :$7? /° 4 Date.Receive,d v oc —p . Phone Contact for Permittin• -- Owner's Name to ones 4 4 V.-(C1/414 '0 7 # �.r .•..I. Owner Phone Number YI 7'? 6021 Owner's Address 625 15 :•4'" - 5 2/ Owner Phone Number 1 Fee Simple Titleholder Name Owner Phone Number I Fee Simple Titleholder Address JOB ADDRESS Ynk/ LOT # 1 12 I SUBDIVISION PARCEL ID #Io-_ vV ^z-1 -c. loo - - 1220 I (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOS D NEW CONSTR ADD /ALT SIGN 1 MOVE 1 1 DEMOLISH INSTALL REPAIR ( c,1 PROPOSED USEi I I SFR I I COMM I I OTHER I I TYPE OF CONSiRUCTION I I BLOCK I 1 FRAME L I STEEL I 1 OTHER 1 DESCRIPTION 4 WORK c - Q- -- rOcrt 110c.4.5& Vol SSA 'Q BUILDING SIZE SQ FOOTAGE loco HEIGHT BUILDING $ , us-co VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS EN r = MI W.R.E.C. PLUMING $ I I I MECH NICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS X ROOFING I J SPECIALTY 1 1 OTHER // �x,® FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES I , INO BUILDER COMP SIGNATURE REGISTERED 1 Y / N I FEE CURRENT I Y / N I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y 1 N I FEE CURRENT I Y/ N I Address I. License # PLUMBER COMPANY SIGNATURE , REGISTERED 1 Y / N I FEE CURRENT I Y / N I Address License # MECHANICAL COMPANY • SIGNATURE REGISTERED Y/ N FEE CURRENT I Y/ N I Address License #, ,�(� • COMPANY 0.V\ RWI�� - 5 4 ,. � �_ REGISTERED L 1 / N I FEE CURRENT I Y / N Aillow Address • som v47' '� � Ill S 33 -1/ License # I C_CC- (J""Z--3-5-0-r- . 0- - RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new protects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2:00, a Notice of Commencement Is required. (A/C upgrades over $5000) ** Agent (for he contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (Plot/Survey /Footage) Driveways -Not over Counter If on public roadways..needs ROW