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oio-rou-vucv vi�y vi �cNiiy��nn� � v������r,f,f.��..�,..�.. <br /> . • Building Department ' <br /> . M G f�! �G (a <br /> Date Recelved Z�� 3� Phone Contact for Permittin � 3 Zb�f _� <br /> Owner'sName O ��� /����G/'1F1'�� OwnerPhoneNumber 0/3'35� <br /> Owner's Address � n I t-1 N l�' �2. /L Owner Phone Number - <br /> Fee S(mple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB AUDRESS �v O (\'1 ���, A�•�- o�,� ZePti R-�� I Z S F� 33s y2 �oT # Z S <br /> SUBDIVISION Si �� e2• 0 Al�S PARCEL ID# �� � Z �� l S� `QQ�QO ' d LS G <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN �] MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PRdP03ED USE Q SFR [� COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL [� OTHER <br /> DESCRIPTION OF WORK �G 2 �✓ /itJ�� c„� (fAJ / 1 �S S 7�� S! Z� �C. I`� 7 fl 6•� ' <br /> BUILDING SIZE �— SQ FOOTA(iE HEIGHT <br /> �] BUILDING $ -Z /�. Q� VALUATION OF TOTAL CONSTRUCTION <br /> (p U � <br /> Q ELECTRICAL �$ � AMP SERVICE �,�� PROGRES3 ENERGY Q W.R.E.C. <br /> � <br /> Q PLUMBING �$ �� 7 j � <br /> � �iU! <br /> � MECHANICAL �$ VALUATION OF MECHANICAL INSTALLATION <br /> � <br /> 0 GAS Q ROOFING Q SPECIALTY C] OTHER <br /> FINISHf'D FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO <br /> -2(09- N�cA <br /> � <br /> BUILDER � COMPANY e � � �-G " <br /> SIGNA7URE REGISTERED N FEE CURRENT Y/ N <br /> Address C',� D X 3 3 DyL! I-r ' 3 Z-$�g License # ���� � <br /> ELECTRICIAN COMPANY <br /> 31GNA7URE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # --� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address Ucense # �— � <br /> OTNER COMPANY <br /> SIGNATURE REGISTERED Y I FEE CURRENT Y/ N <br /> Address License # � <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Buliding Plans; (1) set of Energy Forms; R-O-W Perm(t for new consUucGon, <br /> Minimum ten (10) woricing days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary FacfllUes & 1 dumpster; Site Work Permit for subdivislons/large proJects <br /> COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permft�for new constructlort. <br /> Minimum ten (10) working iiays after submittal date. Requfred onsite, Construction Plans, Stormwater Plans w/ 3ilt Fence Installed, <br /> Sanitary Facilitles 8 1 durppster. Site Work Permit for all new proJects. Ail commerc(al requirements must meet compllance <br /> SIGN PE:RMIT Attach (2) sets of Engineered Plans. <br /> "*"PROPERTY SURVEY required for all NEW construcdon. <br /> �r �. �����„���.� <br /> 11 Y i1J Yi l J1L11L1W1L1 � � R <br /> Dlrections. <br /> Fiil out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over:2500, a Notice of Commencement is �equlred. (A/C upgrades over �5000) <br /> " Agent (for the contractor) or Power of Attomey (for ihe 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 A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />