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Building Department <br /> , ,., 'c, <br /> r-- <br /> iate Racei ed � �j—� Phon4. ntact tor Permittin �S� 3 �-F'�i. `�`i�C S <br /> hnrne�'a N e r�- � � �/Z O C-C..� Ownnr Phone Number �2 3 ��8�� ' �1/S' <br /> Twner's A dress 3 ggB� Ownar Phone Number �; � <br /> 'ee 3impi Titleholder Nams Ownor Phone Number � <br /> �ec�Simpl Titleholder Addreas � <br /> i0E!ADD 33 � / Q� j"��L A-✓� Ze Ph-ri'-l�'��5 l=(. 3 'S ' �f%�L LOT# � <br /> �UBDIVI31 N �'i,1�Q��s ,��#- Z.2p�t2Y�n.'ll5 PARCELIDq �`-.�o-�i -O� t� ` l-L`-1C'U ' �O�-}O ] <br /> (OBTAINED FROM PROPERTY TAX NOTIGE) <br /> YORK PR POSED e NSTALLSTR e REPAIR � 'IGN Q C] DEMOLISH <br /> 'ROP03E USE [� SFR [� COMM Q nTHER <br /> 'YPE OF� NSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> )E.'3CRIP � N OF WORK �� �A l� ��Q i Ei.� +� ` F�+��3� C�RI�J f,���C. r-eNc°f. W iT/� wR t k Caa�G. <br /> lUILDINO IZE � � SQ FOOTA(3E�� IiEI(iHT <br /> � ILDING S � �S.b , UO VALUATION OF TOTAL CONSTRUCTION <br /> [� ECTRICAL S .—� AMP SERVICE [� PROGRESS ENEROY CJ W,R.E.C. <br /> [� UMBIN(3 $ �(,S�I,� <br /> [� ECHANICAL �� VALUATION OF MECHANICAL tNSTALLATION <br /> ��Sc.dX�'nG�'' <br /> [� AS [� ROOFINO [] SPECIALTY �] OTHER _ � <br /> �INISHED LOOR(?LEVATIONS � � FLOOD ZONE AREA [�YES NO G ��Q <br /> �.� <br /> 3UILDER ��/� 7 /�j�f COMPANY ���eS l-�oMt ceNT�2s ' nl c. <br /> >IGNATU G/���- "��_7'� " REQISTERED Y/ N FEE CURRE� Y/N <br /> Addr s C• O G`301� 1 $�1��J �R�'ArvS�<y 3�-$75` Llcense# I�..�oL. � S(� �S �/ �� <br /> ?LECTRI N f COMPANY ] <br /> 31GNATU � REOISTERED Y/ N FEE CURRE� Y/N <br /> L <br /> Addr s [ I License# l � <br /> �LUMBE I -- — COMPANY <br /> 31f3NATU � REGISTERED Y/ N FEE CURRE� Y/N <br /> Addr s � Ucense# __] <br /> VIFCHANI AL ( COMPANY <br /> 31GNATU � REGISTERED Y/ N FEE CURRE� Y/N <br /> L <br /> Addr s � � Llcense# � � <br /> �THER COMPANY � <br /> 31CiNATU [ l RE(313TERED Y/ N FEE CURRE� Y/N <br /> Addr s [ License# I � <br /> RE:SiDEN AL Attach(2)Piot Plans;(2)sets of Buliding Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon, <br /> Minfmum ten(10)working days after submittal date. Required onslte,ConsUucUon Plans,Stormwater Plans w/Slit Fence Installed, <br /> Sanitary FaclllUes&1 dumpster;Site Work Permit for subdivlsions/large proJects <br />�QMMER IAL Attach(3)wmplete sets oi Buflding pfans pius a Uie Safcrt��Page;(1)sst ot Ens;gy Forms.4-O-W Pertnit for new constructlon. <br /> Minimum ten(10)wo�king days after submfttal date. Required onsite,Construction Plans,Stonnwater Plans w/Silt Fence Installed, <br /> 5anitary Facllfties&1 dumpster.Site Work Permit tor all new proJects.All commercial requirements must meet compliance <br /> SICiN PE IT AHach(2)seta of Engineered Plans. <br /> """"PROPERTY SURVEY required for all NEW construcUon. <br /> Directlon <br /> Fill o appllcation comp�etely. <br /> Own &Contractor sign back of applicatlon,notarized <br /> If ov 52500,a Notice oi Commencement is required. (NC upgrades over 57500) <br />'• Agen (for the contractor)or Power of Attomey(for the owner)would be someone wlth nota�ized IeHer from owner authorizing same <br /> OVER TH COUN7ER PERMITTIN(3 (Front of Appllcatlon Unly) <br /> RProofs If Ingles Sewers Serv(ce Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drlv ays-Not over Counter If on publ(c roadways..needs ROW <br />