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Fee Simple Titleholder Name � �-�i�� � , Owner Phone Number <br /> . �_�`� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS - 7` � �' _ �/ �� <br /> LOT# <br /> SUBDIVISION � PARCEL ID# - 6 �- / .-po a .-p o p� '-�?f3 a <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN � � DEMOLISH <br /> e INSTALL 8 REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �c:J �,t,�,s i��� S'�{ � � � ,�� - -� ������,�y��S C�4P�c � ✓ <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> �BUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> �,_- ___,_,,._�,..__..._....._, <br /> " ELECTRICAL $ AMP SERVICE PROGR ENERGY <br /> �j60 ._. 0 Q W.R.E.C. <br /> �n <br /> QPLUMBING $ <br /> .��8. <br /> QMECHANICAL $ VALUATION OF MECHANICAL INST LLATION � <br /> QGAS � ROOFING � SPECIALTY <br /> Q OTHER � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� <br /> Y/N <br /> Address License# � <br /> ELECTRICIAN �'', / � COMPANY <br /> SIGNATURE l�A' ,� � T�� �/�'�7?rcd4� Lo Gr�o.� <br /> "�-`�-�` REGISTERED Y/ N FEE CURRE� Y/N <br /> Address G� ' 7 G.jr��� S'��� 2p�_j License# <br /> �C -� oa � ._ <br /> PLUMBER COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# �— <br /> OTHER COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# �— <br /> IIIIIIIIIIIIIIIIIIIIIIII1111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans; (1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans, Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Pians plus a Life Safety Page;(1)set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "'"PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> ll�..nnr A.!`nnlrnMnr cinn 1..�rli nf.�nnlir.�Iinn nnl.ari-rn.� <br />