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o,r�o�-w�� vny vi �cN��r�un�o � ������..,rr��..�..�..�� <br /> � Building Department <br /> �'� y � `s-���.. <br /> Dats Racsived e� ne¢or�tact f�r Pa_ IWn <br /> Owners Name M A 2 lC � l T— Owner Phone Numbsr <br /> Owner's Address �C Z. TePhe.N s r'}AT1t Owner Phone Number � <br /> Fee 8impls Titleholdsr Name � Owner Phons Numbsr � <br /> Fee Simple Tkleholder Addresa <br /> JOB A�DR�SS (o `�Co 5 i�PI�e,J S (�'!-�l� �-h;�ts r=L 3 3 5�z �ot# 3� <br /> 8UBQN�SION ST�Bbens5 6�� a'r 5�/u�2 PARCEL ID# e 3-2 -�- O�10�•- � - e+3'7 0 <br /> O Ak.S (OBTAINEb FROM PROPEitTY TAX NOTIaE) <br /> WORl�-PRf�R08ED NEW CONS7R ADD/ALT [� SIGN Q [� aEMOLISW <br /> e INStALL 8 17EPA1R <br /> PROF�08ED.UgE [� SFR �] COMM [,� OTHER <br /> TYPE OF CON8TRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DE8CRIPTION OF WORK j�L� I S I i rJ�'N G%�v ol� Lt N S/ S i Z.� FL (`f� �� • �- <br /> BUILDIN(i SIZE SGl FOOTACiE� HEIOHT � � <br /> �'�UILDING S 3.7� s VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL $ AMP SERVICE Q PROORESS ENERGY Q W.R.E.C. <br /> QPLUMBINC3 $ <br /> � '��� � <br /> QMECHANICAL � VALUATION OF MECHANICAL INSTALLATI�N � <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> �. A�-� �---'Z� <br /> BUILDER C" ��OMPANY S NOMC, CQN�'e2� �n/�. <br /> SIGNATURE REGISTERED �e cu�n Y/N <br /> Address O �O 1� � Q�J' ��A�d° �z-S 7 8' License# (C,��oL � .S d ��1 7 <br /> ELECTRICIAN COMPANY <br /> SiGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIONATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# � t <br /> OTH�R COMPANY <br /> SIONATURE REOISTEREO Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> RESIDEN'TIAi. Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new oonstrucdon, <br /> Minimum ten(103 vwrking days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fenve i�stalled, <br /> Sanifary Fadlitles&1 dumpster,Sfte Work Pertnit br subdlvisionsllarge proJects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)3et of Erar�y Fcrms.R-O`1`!P�.^.^!t!o�n�v construcHon. <br /> Minimum ten(10)working days after submtttal date. Required onsite,Conshuction Plans,StoRnwater Plans w/Sift Fence Installed, <br /> Sanitary Facilides 8 1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet comp8ance <br /> SI(iN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'PROPERTY SURVEY required for all NEW consVucdon. <br /> Dlrectiona: <br /> Fili out applica8on completely. <br /> Owner&Contractor sign back of applicatlon,notarized <br /> H over�500,a Notice of CommencemeM is requlred. (AIC upgrades ove�s7500) <br /> "' l�ent(for the contra�ctor)or Power of Attomey(for the owner)would be someone with nota�ized letter from owner authorizing same <br /> OVER THE COUNTER P�RMIITIN(i (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />