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o�ir�uu-uu�u l.�ry v� La�i ryi i nn5 rrsi nin r�NNn�.auv�� •-••-•- •-- ---� <br /> . Building Department <br /> /✓� G,U��c.:. <br /> Date Recelved Phone ContACt f�r Permiltin �� 3 �� — � ���� <br /> Owners Name Orvner Phone Numbar ��� ~ � T�" 3 ��� <br /> Ownsrs Address S �'^^'e- Owner Phone Number <br /> Fee Simple Titlsholdar Name � Ownsr Phons Numbsr <br /> Fee Simple Tftleholder Address ;� <br /> JOB qQDRES3 <br /> J �� i S �U� G.CP�/'Z �1 i ( r S� �`3 S � LOt* C�r� <br /> 8UB�1�1$WN I C�r��� AG/��S � PARCEL ID� �3 'Z�s�iZ.1 �Q(�tt •C:Ot?(?C. � �''�'�s �' <br /> (OBTAINEb FROM PROPERTY TIUC NOTI6E) <br /> WOR14_PROqOSED NEW CONSTR ADD/ALT C� SIGN Q [� DEMOUSH <br /> e INSTALL 8 F2EPAIR <br /> PROF��,8E�.U8E [� SFR Q COMM � OTHER <br /> TYPE OF CON8TRUCTlON Q BLOCK Q FRAME C, STEEL Q <br /> DESCRIPTION OF WORK �i�1 S"rR1 I q cI � O T � I 3�. iS �-�e�JGG �IJ.� � f 'A �,.° <br /> BUILOIN(3 SIZE � 3Q FOOTACiE� HEI(3HT <br /> BUILDING 3 VALUATION OF TOTAL CONSTRUCTION I <br /> i�R9�, �� <br /> �]ELECTRICAL $ AMP SERVICE Q PROORESS ENERGY Q W.R.E.C� <br /> [�PWMBIN(3 S �� <br /> � � h <br /> L]MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> [�]GAS Q ROOFING �] SPECIALTY C�J OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> � G ��d <br /> BUIIDER COMPANY �Ow-6S oMt Cea�'G2� ���- <br /> SIONATURE REGISTERED Y N �e cutt�� Y/N <br /> Address O �O� O Q�J R�ANd° �i-878' Uc:ense# ��o�. � .S(� �3=7�� 7 <br /> ELECTRICUIN COMPANY <br /> 81(iNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Addross Lic�se# <br /> PLUMBER COMPANY <br /> SIONA7URE RE(31STERED Y/ N FEe Cuwt� Y/N <br /> �'d� License# <br /> r <br /> MECHANICAL COMPANY <br /> SI�3NATURE REGISTEREO Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTH�R COMPANY <br /> SKiNA7'WRE REO►STERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESID�NTIAL Attach(2)Plot Plans;(2)sets of Building I�lans;(1)set of Energy Forms;R-0-W Permit for new constructlon, <br /> Minimum ten(10)wo�lcing days after sub�ittal date. Required onsite,ConsWctlon Plans,Stormwater Plans w/Sflt Fence installe�, <br /> Sanitary Fadlitles 81 dumpster,Site W Permit for subdivisfonsllarge pro)ects <br /> COMMERCIAL Attach(3)complete sets of Buflding Plans'plus a Life Safety Page;(1)set of Energy Forms.R-O-W PertMt for new construc�tion. <br /> Minlmum ten(10)working days after subnhittai date. Required onsfte,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlides 81 dumpster.Site Work Permit for all new projects,All commercial requirements must meet compliance <br /> SICiN PERMIT Attach(2)seta of Engineered Plans. <br /> "'""PROPERTY SURVEY required for all�IEW constructlon. <br /> DlrocNons: <br /> Fill out app8cation completely. <br /> Owner&Contractor sign back of applicatlon,notarized <br /> H over,�2600,a Notice of Commencement is roquirsd. (AIC upgrades over s7S00) <br /> " Agent(for the cantractor)or Power of Attomey(for the ovmer)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PEItMITTIN(i (Front of AppUcatlon Only) <br /> Reroofs If shingles Sewers SeMce Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />