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oirrov-vv�v v�tJr v� LvN��y��in�o � a��in�r-�NNnvuaw�� <br /> Building Department <br /> YY1o+�i��l <br /> Date Received Phone�ontact f�r Pe ittin ��'� ��9 -r"J 9!� <br /> Owners Nama F� U � � N /2 t�A Owner Phone Numbe� � - 7/�- �3 S <br /> OwnersAddress s��C OwnerPhoneNumber <br /> Fse 8impls Titleholdsr Mame �— � Owner Phone Number <br /> Fee Simple Titlehoider/l►ddresa <br /> JOB ApDR�33 ��f� J/��S�1 /n H �jZ Z -�ll S �l 3 3 �L/ Z LOT# �� <br /> SU61�11/ISION �P�YR r+°�.,!J�fS PA�tCEL ID� � 2 'Z 6`2-/'�Ya -!a O:�.Oc� C d 8� <br /> (08TAINEC fROM PROPEItTY Tf1X NOTICE) <br /> WORK�P'R�OSED B NEW CONSTR 8 ADD/ALT �� SIGN Q [� DEMOLISW <br /> INStALL aEPA1R <br /> PROF�ED.USE Q SFR [� COMM C] OTHER <br /> TYPE OF CON87RUCT1mIV Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK L N5Y`�A/'1 I Z g� � �h�i Li �4/�N , �l!!c N� � ���C � f t�/ (� <br /> �r4Tt„ <br /> BUILDIN(i SIZE � 8Q FOOTA�iE� HEIf3HT <br /> QBUILDING S ����i �b VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROC3RESS ENERC3Y [� W.R.E.C. <br /> QPLUMBIN(3 $ r I <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � �( <br /> QGAS Q ROOFING Q SPECiALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> G C��.a 1 '��� <br /> BUILDER (.Ow�CS No.�t �eN"r�2� �nl t- <br /> SIGNATURE � RE(iISTERED Y/ N FEE CURRE� Y!N <br /> Address O �O 1� O Q�J ��A�t a�v� 3:-87�' License# ��oG ( .S� ��/ / I <br /> ELECTRICWN COMPANY <br /> 81GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIONATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License# � <br /> MECHANICAL � COMPANY <br /> 31(iNATURE RE(31STERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY <br /> SIONA7URE REQISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construcdon, <br /> Minimum ten(10)wbrking days after subtnittal date. Required onsfte,Construction Plans,Stormwater Plans w/Silt Fence i�stalled, <br /> Sanitawy-Fadliiles 8 i ciumpsfer;SF�e Woric Permii io�subdivisions/large project� <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon. <br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence Installed, <br /> Sanitary Fadlides&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SICiN PERMIT Attach(2)sets of Engineered Plans. <br /> •""•PROPERTY SURVEY requlred for all NEW construcUon. <br /> Directlons: <br /> Fill out appNcaUon campletely. <br /> Owner&Contractor Sign back of appltcaUon,notarized <br /> If over;2S00,a Notice of Commencement is roqulred. (AIC upgrades over 57500} <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with nota�ized letter from owner authorizing same <br /> OVER THE COUNTER P�RMITTIN(i (Front of ApplicaUon Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter tf on public roadways..needs ROW <br />