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..... ....�,, v�t� v� �..vN�����niw � v�����a. .rr�....,,.�..�� <br /> Building Department <br /> Q ''C f� <br /> Date Rece ved Phone:Contact f�r Permittin Z6�t <br /> Owner'a r me C3 n2 C Owner Phone Number � �3�{�-S(0 1 S <br /> Owner's dress Owner Phone Number <br /> Fee Simpl Titleholder Name � Owner Phons Number � � <br /> Fee Simpl Tkleholder Address <br /> JOB ADD E33 - ` �d'T (�1 i � � 3� � LOT# �� <br /> 3UBDNI3 ON ��.S O iJ PARCEL ID# �Z.—�b�,�Ll -O O t�O ��4"��O - '3�4 <br /> (OBTAINEb FROM PROPERTY TAX NOTICE) <br /> WORK P P08ED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROP08 D USE [� SFR Q COMM � OTHER <br /> TYPE OF ON3TRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIP ION OF WORK .�lu STA 1I �-I � i C� t 1-�I� C. � a, �o /2,d i° g� �o A� <br /> BUILDIN SIZE � 8Q FOOTAtiE� HEI(3HT <br /> UILDIN(3 a �,,�6� VALUATION OF TOTAL CONSTRUCTION <br /> � �� <br /> Q LECTRICAL $ AMP SERVICE Q PR0C3RESS ENERGY Q W.R.E.C. <br /> [� LUMBINC3 $ •��� � <br /> / <br /> [� ECHANICAL a VALUATION OF MECHANICAL INSTALLATION � <br /> Q AS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES NO <br /> G ��� 1�-'Z' <br /> BUILDER COMPANY ow NoMt �e�`��2s ,�l c. <br /> SIGNATU E REGISTERED Y FEE CURRE� Y/N <br /> Aaa $S c> C�o�. � $ Q3 RfA���' �z�7�' License# L�G f SOF�l7 <br /> ELECTRI IAN � COMPANY <br /> SIGNATU E REGISTERED Y/ N FEE CURRE� Y/N <br /> Add ss License# I � <br /> PLUMBE � � COMPANY <br /> 810NATU E REOI3TERED Y/ N FEE CURRE� Y/N <br /> Add ss License# � <br /> MECHAN AL COMPANY <br /> SIGNATU E REGI3TERE0 Y/ N FEE CURRE� Y/N <br /> Add ss � License# � � <br /> OTHER � COMPANY <br /> SI(3NATU E REC3ISTERED Y/ N FEE CURRE� Y/N <br /> Add as Ltcense# � � <br /> RESiDEN IAL 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)worlcing days after submittal date. Requfred onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster;Site Woric Permit for subdivisions/large projects <br /> COMME IAL Attach(3)complete sets of i3uiiding Pians pius a Life Safety Ppga;(1)set ot Enss�y Forms.R•�-!^!Permlt fo�new con�bu�ti��n. <br /> Minfmum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanftary FadliBes 8 1 dumpster.Site Work Permft for all new proJects.All commercial requirements must meet compliance <br /> 31C3N PE MIT Attach(2)sets of Engineered PIanB. <br /> """"PROPERTY SURVEY required for all NEW construcdon. <br /> Direction : <br /> Fill o t appNcation completely. <br /> Ovm r&Contractor sign back of application,notarized <br /> If ov r 52500,a Nottce of Commencement Is required. (A/C upgrades over E7500) <br /> "• Age t(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER TH COUNTER PERMITTIN(i (Front of Applicadon Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> D�Iv ways-Not over Counter If on public roadways..needs ROW <br />