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813- 78U -UU2U Lilly 01 pl lyl i nna ruiliiii. nNNnvauvt i ' c Building Department Date Received Phone Contact for Permittin • _ � /__ -_ '416 0 3 63 ' / • Owner Phone Number (8/.3) 769 - -'5 • Owner's Name ; ��i(//✓AIQ Tr O.E�S . Owner's Address 14 DO /V at SfS1FO,r4 8Lv0 1 '4ieg A.-336o91 Owner Phone Number Fee Simple Titleholder Name' 1 Owner Phone Number 1 1 • Fee Simple Titleholder Address 1 JOB ADDRESS I (374 ///7/2W1 VA/ 4I4 ?EP/lyei,via ,1 ,14.33$-'9° 1 'LoT #' 1 9J' I 6 /L/`�ND . //4� . 1 PARCELI #1 03 - 21"0.23 0 r+.dt 000-©' %3D 1 SUBDIVISION. 1 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED Fil NEW CONSTR I ( ADD /ALT I I SIGN n MOVE. I I DEMOLISH INSTALL REPAIR PROPOSED USE n SFR I I• COMM n OTHER 1 I TYPE OF CONSTRUCTION BLOCK I I FRAME • 1 1 STEEL n • OTHER I DESCRIPTION OF WORK I Al Ew Co/vsre.ucri o/v -d wN ,40,44.s ' I BUILDING SIZE 1 1 S4 FOOT A GE 1 �5 3 / 1 , . H ( o?.SI (-0 I FT BUILDING $ VALUATION OF TOTAL CONSTRUCTION . 1 6 S0 , n ELECTRICAL 1$ 4/0 1 AMP SERVICE ® ENERGY r PROGRESS EN W.R.E.C. n PLUMBING I$ V3.• 5 1 N °G ' rn MECHANICAL $ 4 1 ? vs VALUATION OF MECHANICAL INSTALLATION Z 3e pJ' ( GAS ET ROOFING 1 1 SPECIALTY I i OTHER QI , l K (j /U 9� rl FINISHED FLOOR ELEVATIONS - FLOOD ZONE AREA 1 IYES E1NO J s 90 , /0 • COMPANY 1 •/Abbe- N°A•eS BUILDER SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N - P 0A/. Al • • 044 Bi 'a �ictiam, � 334o9 License # • CI3C SST7 / Address ELECTRICIAN / COMPANY 4D/t' 4J 50.A./ 6 E /c- Zi/C . SIGNATURE / - ° REGISTERED ' I Y/ N I FEE CURRENT . I Y / N Address ( , 103y ,S /Pp /w4D, ft- 336/3 License # C 00 0.2.579 PLUMBER COMPANY . SA /! P.M-'VA /N SIGNATURE ' > REGISTERED I- Y / N I FEE CURRENT I Y / N I Address /' 3 V //iv 0/ S I ./2 1.vE210EG '/2 3 3 5 7 $ I License # CfG a /SO O' MECHANICAL / COMPANY 8 oA/�4(iMB /�t/6► f./607ia/6 0 f,�C_ SIGNATURE /� • REGISTERED Y / N I FEE CURRENT I Y / N Address A O. sox og f3RyoNerisv rr, FL3y694/1 License : , CS'c ms$ '. © 6 2 OTHER COMPANY C• s.'rAeL/ �t1Cr' .a9[; ry roc uG, . vc. SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT' ( Y/ N I • Address I / /V/ .5/Yl,L L /uE 81-vo JP44116 Atu, Ci3YIo . License # - CC- - Co s`7 99 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-0-W Permit for new construction, ' Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Pians w/ 5111 Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects • COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (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 projects. 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 $2500, a Notice of Commencement is required. (A/C upgrades over $5000) Agent (for the 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 A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways.: needs ROW •