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o�. a.e.�r.a � con�aee � <br /> owner's,�m. , V - 1' ' I own.► Plan. w�ow.. (S 1 � "� ~ ?S I <br /> "'"' Owner's Addma µ 1 ' �� �� �`�"�� U Ow�w Pho�» NwnbM — 1 <br /> __' Fw Slmpb TldahoMx Nams � O�w�wr Pha�a MNnber �— <br /> Fee Simpk TltNfwld�r Addrass <br /> JOB ADORE83 LOT • � <br /> �,� (�e_St �� c�� P� � ' 1 � � �b l <br /> (��MED FROY PROPfiRfY TAIf NOTICq <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT Q SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q�FR Q C�hIM Q OTHER <br /> rrPe oF cowaraucna+ 0 e�ocEC � Fwv� p s�a. [�� on� <br /> oescwPnow oF wo�ac 1 '� <br /> euwat�o stz� �_ _X �� su �oor� �x�r <br /> Q� BUIIDING n 1 C_ U VALUATI�I OF TOTAL CONSTRUCTION ��'�j Jl� . �lJ <br /> ��' .J�; <br /> Q� ELECTRICAL $ AMP SERVtCE �/ pRpGRESS ENERGY Q W.R.E.C. <br /> d � PLUMB�NG $ - �{/ 1 / �Q `C <br /> MECHANICAL $ VALUATION OF W�CHANICAL IN3TALUITION �F � � <br /> ! <br /> Q GAS Q ROOFiNG Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES �O <br /> �,,. sui�o� � ' � �� �____ coMr�wr � �l �0�1�� { `�.i'L <br /> ' SIGNATURE - aEC�sr�o Y N � c�aENr Y N <br /> Ad�asi 1�IvV �(J� J�-� `+�1 � 3ZC��� Lioenae# � �l ��Z..SL.� u� <br /> � O�EN �/ vlL.l�l, ���t�(J� C FE 7� ����1,� C�IQC�S�. N <br /> naa..� .�I 3S O} ►S A ileri r h� lls r ,.;� # ��1c�i Zq � � <br /> PLUMBER / y �_ COMpANY �5,�' Y H`�b� �'� Z iS� WL-Q �J.1C_ <br /> SIGNATURE � rs�cisr�o Y N � cuqqewr �— <br /> i� v'- <br /> naa� � fJ hl 3rd �G J�,,r.;. � 3z u� x l� 1 D2�S21 G <br /> SKiNATiJRE -y L�� ,G._- q�s'r�o �""Y N ,`, F rl ICT Y N <br /> A�. r� I V �� �14C � t�1 <br /> OTHER �pq�/ —� <br /> 81GNATURE t��sr�eo Y/ N F� cupqerar Y/ N <br /> AddreYS �iCense # �� <br /> RESIDENTIAI. Atiach (2) Pbt Plens: f2) sets d Bupding Ptens: (t) set of Enar9Y Fartn� R-0-W Pennit fot ne�w oonstruclion. <br /> Miremun ten (10) wa�0 deys �ter aibmilfai da�. Required ormile. Constructlon f'Is�s. SEOnrmater Plans w! Sk Fence inst�led. <br /> Sankary FacNties 81 dumpsMr, Site VYark PenMt for �bnsAsrge ptojecls <br /> COMMERCIAL Al�ch (3) t�mplete ae[s d Biid'ng Plens pk�s e Life SafelY Page� (7) set of Ene�9Y Fonns. R-0-W Pe�mit (ar new constructbn. <br /> Minimum ten (10) waking deys aRar wbm�al dabe. Raqutred areke. Corehvctlon Pla�. Stormwater Plans w! Sdt Fence installed, <br /> sanke.y Fac6tles a � air�. sile wak Peemx w► ae r�e�w p�ojec�. w oo�n�al req,a,e�,ls m�se me� �mp� <br /> SIGN PERMIT Attach (2) seis d Fngkieerad Plans. <br /> ""PROPERI'Y SURVEY required for ek WEVU constructlon. <br /> a�: <br /> FiN out appucetion competely. <br /> Owner & Cantractor sign badc d applicaHon, r�arimd <br /> If over S250U. a Notlea of C�t is erquked• (AJC aP9� o� f500b) <br /> .- `� Agerk (for the cortractor) or PoMrer of AManey (far the owner) would be saneone wiU� noteu¢ed � from owner euthorizing seme <br /> OVER THE COUMiER PERIIYTIING (Front d Applicatlon Or�ly) <br /> Reraofs Serrers Service Upgradas AIC Fe�ces (PbtlSurvaYfFoote9e) <br /> Orivaway►Not over CouMer if a� Pubfic rosdwaYS•.r�ds ROW <br />