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Building Department <br /> Date. Received 5 ,A - ©� Phone Contact for Permittln • -- <br /> Owner's Name 3201‘2...S UJ 'QCckro 1 b - IJUWV e-Q Owner Phone Number Wj 780 csg2 Q2 <br /> Owner's Address 506 5t h, 5 t - 7 S i2 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS SaPPTC/ LOT # I I <br /> SUBDIVISION PARCEL ID# 11 -2 -6 -2 1 - W(V `R ox) -0Z ° <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I 1 siorst., 1 I MOVE I I DEMOLISH <br /> INSTALL REPAIR (2100 <br /> PROPOSED USE 1 1 SFR I ( COMM 1 1 OTHER 1 <br /> TYPE OF CONSTRUCTION I I BLOCK f^ [ 1 FRAME 1 1 STEEL 1 1 OTHER 1 <br /> DESCRIPTION OF WORK �1Q Zf Y � O0U _ Wl kvJQ <br /> BUILDING SIZE SQ FOOTAGE .2 WO HEIGHT <br /> I BUILDING $ 5 / j 5 c J VALUATION OF TOTAL CONSTRUCTION <br /> I I ELECTRICAL $ `� AMP SERVICE 1 1 PROGRESS ENE =' 1 I W.R.F.C. <br /> 1 I PLUMBING $ ,i ,1 )/i/ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I GAS Nn ROOFING 1 1 SPECIALTY 11 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES 1 , INO <br /> BUILDER COMPAN <br /> SIGNATURE REGISTERED I Y/ N j FEE CURRENT ( Y / N ( <br /> Address License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT ( Y / N 1 <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y 1 N ( FEE CURRENT ( Y / N 1 <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED ( Y / N ( FEE CURRENT ( Y / N 1 1 <br /> Address License # 1 <br /> OTHE: (C <br /> COMPANY , MYk Rod <br /> Si � � � REGISTERED I Y/ N I FEE CURREN I Y/ N I <br /> Address tivel i!'a /�W M , 1 IN License # Ca— l X ?S <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 (3) 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 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 /> If over $2500, a Notice of Commencement Is required. (A /C upgrades over $5000) <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 (Front of Application Only) <br /> Reroofs Sewers Service Upgrades NC Fences (Piot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />