Laserfiche WebLink
o�o-�ov-w�u �.i�y vi �CNiiy�inna rcii�n�r�NNnwuvii .......... ..... ...._. <br /> Building Depardnent <br /> , r+'�o�,�a, <br /> Date'Recelved Phone�ontact f.or Permittin �f� Z ro 9 ..�'-1 �� -� <br /> Owner's Name ��S C� e Owner Phone Number � �3 ` <br /> `C �7 - Z�.s� <br /> Owners Address 3 ��Z- 7 '"�R v-e. Owner Phone Number �� <br /> Fee 8imple Tkleholder Name � —� Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDR�38 � .Z-y�7 ,/� Z-����ic..Y h�I 1 S J-L �3�5''2 LOT# � <br /> SUB[�IYI.SI�N ��-�TS � PARCEL ID# ,2-2 6—�I - 0o y O ° D o E�pp - OC_)JSt, <br /> (OBTAINED FROM PROPERTY T/tX NOTIGE) <br /> WORlC PROPOS£D NEW CONSTR ADD/ALT [� SIGN [� Q DEMOLISH <br /> INSTALL e REPAIR <br /> PROROSED U3E Q SFR Q COMM �� OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME �] STEEL Q <br /> DESCRIPTION OF WORK � U (,.._ " I� v�� t A c. �.7r��! "3 S�R S l�„� !� P �/� <br /> BUILDIN(i 81ZE � SQ FOOTA(iE�� HEI(3HT `SY ' -" " ' <br /> QBUII.DING $ VALUATfON OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERC3Y [� W.R,E.C. <br /> 1�1 so f..��,� �7 sy�e ,� <br /> QPLUMBINC3 $ <br /> IJrU�, OU W..LCT SySTe� �3GCn. lyv � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> '"�"'"��ra l. ?'�d7� <br /> QGAS Q ROOFING Q SPECIALTY [—� OTHER `� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �j � <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIONATURE RE(iISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � COMPANY ��� �`.�G u�- <br /> 31�3NATURE �J REGI3TERE0 Y/ N FEE CURRE� Y/N <br /> Addross �f 2 � MA �rR/Za B �, 7qmP,� -� 33� 1 � Ucense# CAc� ��i 3 3 fo5'—� <br /> OTHER / -�,� ,� ~p� � COMPANY <br /> SIONATURE C�i���"���� REOISTERED Y! N FEE CURRE� Y/N <br /> Addreas Ucense# � � <br /> RESID�NTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-0-W Permit for new construcdon, <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Sllt Fence installed, <br /> Sanitery Fadlides d�1 ciumpster,Site Wo►k Pertnit for subdivislonsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(9)set ai Energy�orms.P.-O-W Pemeit far nsd►+construcUon. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucHon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilides 8 1 dumpster.Site Work Permit for all new projects.All commerclal requirements must meet compUance <br /> 310N PERMIT Attach(2)sets of Engineered Plans. <br /> """*PROPERTY SURVEY required for all NEW consUucdon. <br /> Directlons: <br /> Fill out appNcation compietely. <br /> Owner&Contractor sign back of applicallon,notarized <br /> If over i2S00,a Notice of�ommencement is requlred. (AIC upgradea over i7S00) <br /> '• Agent(for the c,ontractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner autho►izing same <br /> OVER THE COUNT�R PERMITTIN(i (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Foatage) <br /> Driveways-Not over Counter If on public roadways..needs ROW <br />