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••••! v��.••p•���n, u� o �a�yNna.auVn �aa-ouvw-wci <br /> Buildin9�ePartment <br /> Date Reeeived 0 <br /> Phone Contact for P�rmittla �, _ � <br /> �. Z8 �?/4aew {��g/�l-�i o��.c�f�.� t� �� 3 -7 g.z, -SSe�' <br /> 3 a�s n ✓t l fY�Owner phone Number <br /> Fee Slmple Titleholder Name Ow�er Phona Num�er �_ <br /> Fea Slmple Titieholtler Addrsss ___ <br /> � <br /> JOB ADDRESS � p�S O A �� F�� LOT# �� <br /> SUBDNISION PARCEL�D# � +�,t" O��O' O��O'�O��Q <br /> (UBTNNEOF�PROPERiYT�710E)DEMOLISH <br /> WORK PROPOSED e NEW CONSTR ADD/ALT � SIGN <br /> INSTALL 8 REPAIR <br /> PROP0.SED USE Q SFR Q COMM � OTHER C <br /> TYPE OF CONSTRUCTION Q g�pCK Q FRqME � STEEL Q <br /> DESCRIPTION OF WORK N tJhl � <br /> BUILDING SIZE SQ FOOTAGE HEIGHT C� <br /> QBUILDING ; <br /> VALUATION OF 70TAL CONSTRUCTION <br /> QELECTRICAL S AMP SERVICE � <br /> PROC,YiESS ENERGY Q W.R.E.C. <br /> QPLUMBING �� � <br /> �MECHANICAL S �� VALUATIONOFMECH/WtCALINSTALLqTION� (��� <br /> O� Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLO00 ZONE AREA QYES NO <br /> BUILUER � COMPANY <br /> SIGNATURE REp5TEf1ED Y/N FEE CURRE� Y!N <br /> Address <br /> Licens:# <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE r�crsr�o Y/ N FEE Curer�n Y 1 N <br /> Addrass License p � <br /> PLUMBER COMPANY � <br /> SIGNATURE REGSTEREO Y/N ���qRE� Y/N <br /> Addrass <br /> L.ICClISfI# <br /> MECH/1NICAL COMPAHY S �C„ ^ <br /> SIONATURE _ �Gisre�o Y!N �FCURree► Y!N <br /> Address /t/[ � �l <br /> ���Lic�se# � � <br /> OTHER � COMPANY <br /> SIGNATURE ttEds�rtEp Y/ N FEE CURREA Y/N <br /> Address License� �— <br /> RESIDENTIAL Attach(2)Pbt Ptans;(2)sats of BWldbg Plans;(1)set of Energy Forms;R-O-W Pemri[lor i�nr cpnsWcdon. <br /> Minimum ten(10)wwking days after submittal dete. ReqWred onaite.ConsWctlon Plans,Stormwa(er Plans w!Silt Fence installed, <br /> Sanitary Fadlities&7 dumpster;Site Work Permit for subdivis'wn.allarge projeets <br /> COMMERCIAL Attach(3)complete sets of guadi�g plans p�us a Ufe Safety Page;(7)s�ot Energy Forms.R-O-W Perrrdt For new construdion. <br /> Minimum ten(70)working days after submittal dale. Requlied onslte,Conshuctlon Pians,Sbrmwater P�ans w!Silt Ferue installed, <br /> Senitary FadRtles 6 1 dumpster Sile Work Permit tor all new projects,qq p�mme�ciy�eq���¢�ents must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered plans, <br /> ""PROPERTY SURVEY reqttlred fpr aU NEW consfruction. <br /> -TllIIITIT <br /> Dlrections <br /> FiU out appllcation completely <br /> owner a contrsctor sign tadc or appllcauon.rwmrized <br /> H ove►=25D0,a Not(ce oT Commsneemerk is requirsd. (A/C upgradea over S7S00) <br /> •• Agent(for the contraCOr)or Power ot Attomey(for the owner)would be someone with notarizetl kN[er/rom ow�er authorizinp same <br /> OVER THE COUNTER PERMITTiNG (Front of App9catbn OMy) <br /> Reroo/s if shh�gles Sewers Service Upgrsdes A!C Fances(p�pbSurvey/Foo1�e) <br /> Oriveways-Not over Counter N on public roadways..needs ROW <br />