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..... ...._., vn� vi r_vN�i���uiw i v�����a, .rr��......�.,�� <br /> Building Department <br /> �r � , <br /> Date Rece ved ' T <br /> Phone Contact for Permittl� �a 3 Zlc,q - R S <br /> Owners me s�t�RR Y W 2 Rew� Owner Phone Number ��3 -�l 1'-1 ' S'-!? ! <br /> Owner's dress S��-�e.. Owner Phone Number � <br /> Fee 8impl Titleholder Nama �— Owner Phona Numbor �— <br /> Fee Simpl Titleholder Addre��s <br /> JOB ADD ESS J�'1�'{'8 1 ST� ZE'-PJ1{t h�l I S �L 3 3 S�f� LOT# � � <br /> 3UBDIVI3 ON �t}� ��- Z.gP{,R4 Z►:(�5 PARCEL ID# � -��-�1-G��j� - 1``'t p - Q��G <br /> (OBTAINED FROM PROPERTY TAX NOTIGE) <br /> WORK P p08ED NEW CONS7R ADD/ALT � SIGN [� �] DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROP03 D USE Q SFR Q COMM Q OTHER <br /> TYPE OF ONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCRIP ION OF WORK 1.ns STA 1 I 3 6� 4t L)c�`l L �� �"}�B� }<-�3 Lt ��� Z. w A����+�c S <br /> /_ t2 �o.<b�c <br /> BUILDIN SIZE � � SQ FOOTACiE�� HEI(3HT � � w ' `,��i s <br /> � UILDING � VALUATION OF TOTAL CONSTRUCTION <br /> c-�'!O`z S. o c� <br /> Q LECTRICAL �� AMP SERVICE Q PROORESS ENERGY Q W.R.E.C. <br /> [� LUMBINC3 � � S� <br /> Q ECHANICAL a VALUATION OF MECHANICAL INSTALLATION � <br /> l �vv <br /> � ' <br /> ns �U Z� <br /> Q Q ROOFINO Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES NO <br /> L C�F�2-d �..'Z" <br /> BUILDER � COMPANY Ow-eS NoMt, �ea"'r�2s' ,n/C, <br /> SIGNATU E ��� REGISTERED Y/ N FEE CURREt� Y/N <br /> naa s$ C� C�ou ` $ 4�✓ a�'A��� 3�-���' ucense# G�oG l SO F�-! 7 <br /> ELECTRI IAN � COMPANY <br /> SIGNATU E REGISTERED Y/ N FEE CURRE� Y/N <br /> Add ss License# � <br /> PLUMBE � COMPANY <br /> 310NATU E REOISTERED Y/ N FEE CURRE� Y/N <br /> Add ss License# �— <br /> MECHAN AL � COMPANY <br /> SIGNATU E � REGI3TERED Y/ N FEE CURRE� Y/N <br /> Add ss Lfcense# � <br /> OTHER � COMPANY <br /> 31(iNATU E REt31STERED Y/ N FEE CURRE� Y/N <br /> Add ss Llcense# � <br /> RESIDEN IAL Attach(2)Plot Plans;(2)sets of Buliding Plans;(1)set of Energy Forms;R-O-W Pennit for new construcUon, <br /> Minimum ten(10)working days after submittal date. Requlred onsite,ConsWctlon Plans,Stormwater Plans w/Silt Fence installed, <br /> San�tary Fadlfdes&1 dumpster,Site Work Permit for subdivislonsAarge projects <br /> CONiiIIE IAL Attach;3)complste sets of Building Plar,s plus s Life Safety Page;(1)set of Energy Forms. R-O-W Permit for new conshucdon. <br /> Minimum ten(10)working days after submittai date. Requlred onsite,Constructlon Plans,Stormwater Plans w/Sflt Fence instailed, <br /> Sanitary FadNties&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compllance <br /> 31(iN PE MIT Attech(2)sets of Engineered Plans. <br /> "'""PROPERTY SURVEY requfred for all NEW construcUon. <br /> Direction : <br /> Fill o t application completely. <br /> Own r&Contractor sfgn back of application,notarized <br /> If ov r t2500,a Notice of Commencement is required. (A!C upgrades over;7S00) <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 PERMITTING (Front of AppllcaUon Only) <br /> Reroofs if sh(ngles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driv ways-Not over Counter if on pubiic roadways..needs ROW <br />