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MODEL CiENTE6Z (Y/6�➢� PLA�NS OIl9 �B�E �l'/RI) P620�6A�'E PFZOi/@DER (1(/Y�I) &�RYVAY'E 9NS�ECTI�NS (lf/PV) <br /> PERMIT VERIFICATION FORM <br /> SEQUENCE NO: OVVNER/�UILDER: <br /> LOT NO.: JOB DESCRIPTION: <br /> PERMIT REVIEW CFiECK�.IST' <br /> CHECKLIST COMMENTS CHECKLIST ITEM DATE COMPLETED/INIT. <br /> � Le al Description Verified <br /> 2 Address <br /> 3 Contractors Si natures/ID# <br /> 4 Prior Permits Reviewed <br /> 5 Zonin Reviewed <br /> - 6 Site Development Standard <br /> Reviewed <br /> 7_ En ineered Plans <br /> 8 Ener Calcs <br /> 9. Product A roval <br /> 10 Site Plans <br /> 11 Drivewa Connection <br /> �2� Fiil Affidavit <br /> 13 Geotechnical Statement <br /> �4 Owner/BuilderAffidavit <br /> 15 Other Affidavit <br /> 16 Se �tic Tank Permit on File <br /> �� Water/Sewer Letter <br /> �8 Power Co Letter <br /> Sent: Returned �9 Draina e Plan/Review <br /> 20 Substantial Packa elContract <br /> 22. im act Fees <br /> 23 Plans Reviewed and Approved <br /> 24 ONOC/Stam ed Envelo e <br /> ZONING NOTES PLANS PAID <br /> SITE PAID� <br /> RD CONNECT PAID <br /> BUILDING NOTES M15CELLANEOUS <br /> RECEIPT#� <br /> S9TE RE@/IE1lV Da4T/� <br /> Wind Zone. mph Comments on Screen (See F12) <br /> Elevation Certificate Required (circle one) Y or IV <br /> OTHER NOTES <br /> Flood Zone Designation. <br /> BFE. Required FFE EGE. <br /> Panel#� <br /> Zoning District: <br /> Minimum Setbacks� F S R <br /> Trees Required (circle one) Y or N Number _ <br /> Sidewalks Required (circle one) Y or N <br /> Land Use Classification <br /> Prepared by� Date� <br /> PLEASE BE'SURE TO COMPLET�REVE'RSE SIDE IN FULL 7"O PREVEIVT DELAYS /iV PROCESS/NG <br /> wpdata/public/bcs/bcs forms/permitverification_2011-05-17 Page 1 Of 2 <br />