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a��-7ao-oozo Gi�ry o1'��pnyrni�is r�r�►�,LhN��«�n����� . <br /> Building DopartmenL• <br /> . . { . l : . . s3/ <br /> �/3 _ 7�� -::-- - --------------� <br /> �- � -- -- - - <br /> DateReceivod � '�� PhoneConfiacC�forPenniti:inc� �-I-I-r- - _" <br /> - -- ------ ---- -I-t-t-t-I-i-1-t -- / <br /> - - --- -- --�C-- - ---- / �l= S��l . <br /> =1-1-1-I-t-rl-I-l-I-1-I-I-rr---- /� OwnerPhon�Number �4��� r <br /> owner`s Name �C/� �� `�- . ' <br /> 3 y;�� �d ,// // •�� Owner PI�one NumUet' <br /> Owner's Acldress <br /> hK-1 <br />! Owner Phono NuniUer <br /> ree.Simp,le Titleholder Name • . . ' � <br /> 1=ee 5imple TiLleholder Address , � �.OT�F f�d . . <br /> 3 9 7�-� �' � �� � � � <br /> J013 ADDRG5S • , _. <br /> .__ -� - . !�'1� eJ��e.- - -- . - nAr�cer�in�t ��-aZ(—d--/—OC?�3_�- 00000-�_IS��_._ _ _ <br /> Y SULip1V1510N [0137AINED f-ROM PROPGRTYTAX NOTICC) <br /> • � ADD/ALT ]�] SIGN 0 MOVE [� DGMOLISI-I . <br /> iNORIt PROPOSGD ' NCW CONSTR ❑ ���AIR . <br /> �: INSTALL • • . OT!-(CR <br /> PROPOSGD USC' � ' � pLOCit � COMM CI OTI-IER <br /> ' rRAMC ' ,� STGGL � <br /> 'I'yPG OP CONSTRUCTIbN 0 <br /> �Qo�n ��� /aL /�/ rc��J � �°���- <br /> pCSCRlPT10N OF WORK ' , . ' ' • <br /> • SQ FOOTAGC "�� 1-1CIGI-I'C <br /> I3UlLDINC SIZC • , � ' <br /> � DUILDING �I� � � VALUATION OrTOTAL CONSTRUCTION . <br /> �.S �a OO. � W.f�.E.C. <br /> AMP SCRVICC PROGRGSS GN�RGY • <br /> � GLGCTf�ICAL �G . • � . ��(f��L���C�.�s��,� <br /> � PLUMBLNG :G. (��3�7A.�-�14 . <br /> . �A:( i-$�-£92�-7$�� <br /> � MCCI-IANICAL :G ; VqLUATION OI=MECI-IANICAL INSTALLATION • `����� <br /> SPCCIAL.TY � OTHER � <br /> � CAS � R001=1NG [� � . <br /> 1=1NISI-IED FLOOR�LGVATIONS. FLOOD ZONCAREA [�YGS ��� <br /> . ' ' ` a COMPANY �� ��, <br /> 13UILDCR �=-?��-- �� � � R��isreR�n Y/ N r-�e cuRRCNT Y!N <br /> SIGNATURC <br /> la.lS�f �i� l � • ' . License�1� <br /> Adclress : ��L y j__ • • <br /> � t Q COMPANY ��' T"" • ��GG <br /> CLCCTRICLAN C\ � O A � ` [�EGISTGRL-� ' �Y/ N FGG CURRCNT Y/N <br /> SIGNATURG ' <br /> � �Q•Qdx /S3� • 1.icense�t <br /> Aciclress • ( �' <br /> �� Gu-h��Jl/1 <br /> ' �'Wd COMPANY 3� � <br /> ��-UM�=r' � `' RCGISTERED Y/ N. r-�c c RRENT Y/N <br /> SIGNATURL- . .,.._/ r <br /> Addross �7oZ•�� cS/1- .S,3� S Gl , � /y 3 d� GJ � �/ • License� L <br /> ' ����� " • Q V� COMPA�IY v�^ � �� � � � , <br /> IVICCI-IANICAL ����'�", � � t Y/ N fEE CURRGNT Y(N <br /> �-.� RCGISTGRCD <br /> SIGNATURC ' � , <br /> ��y/ /� �� ' .License��� : <br /> Acldress CL , . <br /> • COMPANY <br /> OTl-ICR • RHGISTGRCD � Y/ N PGC CURf��NT Y/N <br /> SIGNA'f'URC „ � <br /> • ' License�t <br /> Acidress • • - - ---- --- - - -• <br /> RCStD�NTIAL Atfach(2)f�ot'f'lans;(2)s�[s oi I3uil�inc�Plans;('1)sel of Gnerc�y 1=orms;R-o-�1 Permltfor new construcHon, <br /> Mlnimum ten(10)worl<ing days after suUmillal dale. Required onsito,Co�struc[ion Plans;StormwaLor Plans w!Silt f'ence installed, <br /> Sanitary f=acilitles&1 dumpsier;5ite Worlc Permii•for suUdivisionsllarge projecls <br /> COMMCRGIAC Attacli(3)complete sets of Buildinc�Plans plus a Life Safety Pag�;(1)sel of Gnerc�y.'1=orm S or�mwat r nl ns�wl Slll'I=�n�o(nstalled, <br /> Minimum[en(10)worlcing days after submittal date. R�quired onsife,Construction Plans, <br /> Sanitary 1=acilifiies&1 dumpster.Silo Worlc P�rmft�Cor all new nrojec[s.All commercial requiramenls musL meel compliance <br /> ' SIGN PCRMIT Att�ROPERTY SURVEY r hu'tred(or all NEW constructlon. � � <br /> ***� <br /> ' -t-i-hl-I-1-f,-I-hFl-hf-i-l-hl-I-l-hl-1-1-1-1-1-1-I-I-1-i-I-I-hl-1-I-I-Fl-I-1-I-1-I-1-I-1-H-I-I-I-I-I-1-1-I-I-1-1-1-1-1-I-1-I-I-1-1-1-1-1-1-1-I-1-I-I-I-1-I-1-1-I-I-I-i-I-1-]-I-I-1-1-1-I-hl-hl-hl-I-1-1-1-1-f-I-1-I-1-1-1-1-I-1-1-I-1-I-hl-I-l-I-I-I-I-1-1-1-1-1-I-I-hl-i-i-l-1-1-P <br /> DirecEions: . • ' <br /> F(11 ouCapplicalion completely. , • <br /> Owner&ConG'actor sic�n bacic of application,notarizod <br /> If over�2500,a Notice ot Commencemenfi is requir�cl. (AlC upc�rades over:G5000? <br /> ** AgenL(for the contractor)or I'ow�r of P:Ltorney(for U�o owner)would b�someone wit11 notarized Ietter�From owner autliorizing same <br /> •OVGR TI-IC COUNTCR P�RMITTING (f-'ront of Application Only) . <br /> Reraofs ' Sowors Sorvic�Upgrades A/C 1=ences(PlollSuiveyll=ootage) <br /> p►•iveways-Nol over Counter ifi on public roadways.:needs ROW <br />