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i Building Department <br /> ►-,-�a,����_� <br /> �ate Recel ed , —�—I Phon . ,ontact for PecmlNin (� 1 3 2-(c Q -� �s <br /> hnrner's N e `� � S t7� i Ownc�r Phone Number �i 3 -� �3 - �� �2- <br /> rivner's A dress[�-L l� S / ��� �� Own�r Phone Number <br /> 'ee Simpi Titleholder Nams Ownor Phone Number <br /> �ee�3impl Titleholde�Addreaa <br /> iOHADD 33 �.J�iC��J �f+2�c. cIR ZephRy�+��J�S �1- 335��/'Z� LOT# �� <br /> tUBDIVl31 N �������- t't�-t,h�t7S � PARCELIDtt ��-�E' '�� - Qf' 3c`7 -DOiOc7 - OOS� ] <br /> (08TAINED PROM PROPERTY TAX NOTIGE) <br /> YORK PR POSED e NSTALLSTR� REPAIR � �I�N � � DEMOLISH <br /> �RqP03E U3E [� SFR Q COMM C� nTHER <br /> YPE OF N3TRUCTION Q BLOCK Q FRAME Q :iTEEL Q � <br /> )E:3CRIP � NOFdVORK --�S'�A�II ( IS� OT -7 � �r9� C�AitJ �.t'N� �`^e-��= w 'n^ r � , �q� <br /> lUILDINO IZE C,,_ 3Q FOOTAOE� IiEI(3HT <br /> [� ILDING $ jso e . �� VALUATION OF TOTAL CONSTRUCTION <br /> [� ECTRICAL �� AMP SERVICE [� PROGRESS ENEROY Q W.R.E.C, <br /> [� UMBINC3 �� • ��� <br /> ��� � <br /> [� ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �' �/ <br /> /�Su,�� <br /> t� L <br /> [� AS [� ROOFINC3 [� SPECIALTY Q OTHER <br /> �INISHED LOOR 1=LEVATIONS FLOOD ZONE AREA QYES NO <br /> G �,e.d �.J <br /> 3Uil.oER CO ANY l.ow e1 l�oMt ce�T�2s ��- <br /> iIGNATU REOISTERED Y/ N FEE CURRE� Y/N <br /> Addr s C� O �30 1� � �f��J R-�A lJ�cy 3�-�'75 Llcense# �.�o ..S(� -,L_1_ <br /> ?L�CTRI N � COMPANY <br /> 31GNATU [ REOISTERED Y/ N FEE CURRE� Y/N <br /> Addr s � Lfcense# <br /> �LUMBE � COMPANY <br /> iIC3NATU [ REGISTERED Y/ N FEE CURRE� Y/N <br /> Addr s [ � License# I � <br /> N�CHANI AL COMPANY � <br /> 3 1 G N A T U [ R E O I S T E R E O � Y/ N FEE CURRE� Y/N <br /> Addr s �, � License# <br /> �7HER ( COMPANY � <br /> 31CiNATU 1 REC4ISTEREO Y/ N FEE CURRE� Y I N <br /> l_ <br /> Addr s � � Lfcense# <br /> R�SIDEN AL Attach(2)Plot Plans;(2)sets of Buliding Plans;(1)set of Energy Forms;ft-O-W Permit for new constructlon, <br /> Minlmum ten(10)wo�{Cing days aiter submittal date. Requfred onslte,ConsUucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities&1 dumpster;Sfte Wark Permlt for subdivislons/large proJects <br /> �:;�v�h!�R t�1:. Attach(3)co�:r!et9 sats o!f!u!!dl�g P��na gl!.�s a!!fe�s'.sty P�ge;!1?sPt of�ner7Y Forms.R-O•W Pertnll ior new conshuctlon. <br /> Minimum ten(10)wo�king days after submfttal date. Required onsite,Construction Pians,Stormwater Plans w/Silt Fence Instalied, <br /> Sanitary Facllitles 8�1 dumpster.Site Work Permlt for all new proJects,All commerclal requirements must meet compllance <br /> SICiN PE IT Attach(2)sets of Eng{neered Plans. <br /> """"PROPEf2TY SURVEY required for all NEW constructlon. <br /> Direction <br /> Fill o application completely. <br /> Own &Contractor sign back of applicatlon,notarized <br /> If ov 52500,a Notice oi Commencement Is requlred. (NC upgrades over E7500) <br /> �• Agen (for the contractor)or Power of Attomey(for the owner)would be someone with noterized letter from owner authorizing same <br /> DVER TH COUN7ER PERMITTIN(3 (Front of Applicatlon Unly) <br /> Reroofs if Ingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drlv ays-Not over Counter if on public roadways..needs ROW <br />