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...,,__-- ..�tr ..�� L,vh.��J��u��.� , ..,�,�....�..r...,..,...,.. <br /> Building Deparkment <br /> r'n t9,v�c;a <br /> pate Rece ved � � ��( , . � phane:Gantact f,or Pemilttin � <br /> �t3 26� - �1�5". �� <br /> � '`� . _ <br /> � Owner's N me µ° ��o�1�2� rt„_JA � Owner Phane Number <br /> Qwner's dress ����� ' Owner Phone Number � � <br /> �� I <br /> Fes Simpi TiNeholdar Name � ,__ ; � Owner Fhone Number �� � <br /> i � <br /> ; , .. <br /> Fee Simpl Tttleholder Address ! ' <br /> � <br /> .roB a�a� Ess ��"�b �-u.��}t.._��'�S c1,e- 'Z�..f'�,rrY 1���11s r-�t'�3s�2 �.o�r� -� z'� <br /> suso�v�s or� ��t—f-t la���'�[�� PARCE�.ID# �1 L.-2..10�2t-b 2.��-c�� P �3 t�b <br /> � (OBTAINED FR�Q._M PROPERTY TO TIG�)DEMOLISH <br /> wo€�K.� ��osea ra�w co�s�R .aa��A�.r s��i� <br /> e tNSTALL � 8 R`EPA1R � <br /> PROPOS D.U8E (�. SFR � (�J COMM �] OTIiER � <br /> ?YPE QF ONSTRUCTION � Q BLOCK � Q, FRAME C� STEEt� Q <br /> t1E3CRtP ION OF WUF�K � ���r4C.� 1 ± S�i c�i a.j i��'ao� t.ta�t i"r S=Z�.. S i 2t �C-2 C��dc <br /> BUtLDIN, S#ZE � � SQ FOQTA6Ei�� HEIGHT ��� <br /> Q UtLDiNt3 $ i ; <br /> '(a`��rC.�`�� VALUATlON OF TOTA�CflNSTRUCTION <br /> Q l.ECTft1CAl. � ; AMP SERVlCE � Q PROGREBS ENERGY [� W.R.E.C. <br /> ; <br /> Q LUMBIN4 ($ � <br /> (�_ <br /> [� ECHANICAI. �..,� VALUATlON OF MECNAN}CAL.INSTALLATlON �"�,,.,���tl� <br /> Q AS � RqOFlNG; CJ SPEGAI.TY`[,,,� OTHER (�� J� <br /> t <br /> FINISHED FLOOR ELEVATIONS FL40D�ONE AREA QYES NO <br /> T� � £-k72.�3 �� <br /> BUI�DER C�MPANY .t�_bw-eS_.l�a�+�C, Ge���elZs� �aJ c., <br /> SIGNATU E REGI3TERED Y I IV FEE CURRE� Y I N <br /> aaa► ss t� �a� $ �i�a; /L�'��td� ��-�7�' �ioense# ��G l 5� �l 7 � <br /> EL.ECTRI tAN COMPANY <br /> SIGNATU E REGISTERED Y/ N FEE CURREA Y/N . <br /> Addr ss � License# �� 1 <br /> PI.UME3E , GG?MPANY <br /> SIONATU E i REGI8TERED Y/ N FEE CURREA Y/N <br />( Addr sa! liCense# � � <br /> � <br /> i M�cHnH A�., coMea�v <br /> SIGNATU E , REGIStERED Y f N FEE CURRE� Y/N- <br /> Add ss , Clcense# �— � <br /> OTHER ' COMPANY <br /> 81C3NATU E ' I REGISTERER Y f N FEE CURRE� Y J N <br /> Add ss � Llcense# �� � <br /> � <br /> REStDEN tAL Attaich(2}Plot Plans;�2j sets of Bililding.Pians;{1)set of Energy Forms;R-O-W Pennit for�ew consWction, <br /> M(nimum:ten(10)woricing•days after submittal date. Requir,e.'d onsEte,Constructian.Plans,Starmwater Pl�ns w!S31t�ence ins#a11ed, <br /> Sanitary.F.acilitles_&1 dumpstar;3(;te Work Permit for�subdlv�slonsAarge.proJects <br /> lCOMME iAt, A#tach{3}camplete sets af�ullding Plans plus a�11fe Saie�y-Page;�R;set u����i£rg�+-t=c�rns:P.-Q-Vl�P�rmlt-for-ne�r-c�nstc�ctl�n._�:�---_ <br /> Mlnlmum ten(10)workfng days after submittal da#e. Required onsite,Construction Pians,Stornnwater Plans wJ Sitt Fence�instalted, <br /> Sanitary.Facillties&1 dumpster.81te Work Permit for all new proJects.All commerclal requfrements must meek compliance <br /> StGN PE MIT Attach{2}sets af Englneared P.tan�. <br /> "'•PROPERTY SURVEY requlred�for all NEW canstruction.' <br /> Direetian • ' <br /> Ffll o t applfcation completely. � <br />� Oum r 8 Contractor slgn back of appllcatlon,notadzed <br />� tf ov r S;?500,a Nottce af Commencement Is required. (A!C upgrades aver 57500} <br /> "" Age t{for the contractor)ar Power of Attamey(far the owner)wauld be someone with notarized letter from owner authorizfng same <br /> OVER TH CaUNTER PERMIiTING (Front,of ApplEca�on Only} <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage) <br /> Drtv ways-Not over Counter tf on pubiio roadways,.neads ROW <br />