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•"" ""�" v�aJ vt L.vN�rJ�i«�w e vr�ir�ar aNYs�vwa��ve� <br /> Bufidin�peparbnent <br /> r.t,'C 9 <br /> Date Reae ved ="�( phone ontact f�r Penmlttln l3 26�t — �i � �,, <br /> OwnePs me Owner Phona Numbor -7.��- Q 3 <br /> Qvme�'s dresa ���J;� O�nmmer Phane Number �_T � <br /> Fee 8impt Tftleholdar Nams Ow»ar Phons Numbes � 1 <br /> Fee Simpi Titteho#der Address <br /> aos,�►�t� ss f}- 22�lati i ��. 33 2 �.oT� ��.� <br /> sus�ro�sar� GeytoNy }leigk-t-s � PARCEI.iD# "ZC�,-�,1-t� -c',�t`3L#oo �a�.9Q <br /> (OBTAINLb FROM PROPERTY TAX NOTIG@) <br /> WORK P P08EC e NEW C4NSCR 8 Ap0lALT [� 5!O!+! � Q DEMOI.ISN <br /> 1NSTALL REPAtR <br /> PROPOS D USE Q SFR � COMM �� OTHER <br /> 'Y'YPE OF ON37RUC'fiON Q BLOCK Q FRAME �„� STEEL Q <br /> DESCRtP N C}F WQRK ��114 � I l.J t � S I 1►3� � L�F'.2+v i n} S S i 2.�.. S.`'�. `�' � S� i sa� <br /> ,l�oa:Q 4,��tS�Sit2 <br /> BUILDIN SIZE �� 84 600TAt3E�-�� HEtt#HT ��._�� <br /> [� UILDlNC3 � (�s���L� VALUATION flF TOTAt.CQNSTRUCTI4N <br /> !w <br /> Q LECTRICAl. � �( AMP SERVICE Q PROORH$3 ENERGY Q W.R.E.C. <br /> J <br /> [� LUMBIN4 �� t f�� <br /> � i�-ti <br /> (� ECHANlCAL s VALUATION OF MECHANICAL INSTALLATION <br /> C) AS Q ROOFIN(3 � SPECIAL'TY [,� OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO <br /> G C-k i2»c� 1� <br /> BUI�DER ` �s � COMPANY L oc.r-e S Ejar�+{, G N��lt�s` 'n/c, <br /> SIGNATU E ��7�"�' y��� �` REGI3T'ERED Y! N �e cuRRE� Y/N <br /> Add ss C3 �O� A `��J +k-�A,^�{e�{sr �"��7�" IJcense# �,�� l ,��} .f"''S�1„�� <br /> EGECTRt IAN COMPANY <br /> $ICaNATU E REG18TERED Y/ (V FEE CURREt� Y/N <br /> Add ss t.lcense# 1 � <br /> P�.ltMBE COMPANY <br /> 81ONATU E REGI3TER@D Y/ N FEE CURRE� Y/N <br /> Add s: License# �� � <br /> MEGHAN At. COMPANY <br /> SIt3NATU E RE(iiBTERED Y/ N FEE CUR�EA Y/N <br /> Add ss Ucense# �� � <br /> C?THER �� COMPANY <br /> SIf3NATU E REt318TERfD Y/ N FEE CURREN Y 1 N <br /> Add ss �icense# � i <br /> RESlQEN IA4 ABach(2)Plat Plans;(2}sets of BuAding Plans;(1 j set of Energy Forms;R-0-W Pertnit fo��ew consUucdon, <br /> Minirnum ter►(10)w�o�rking days atter submittal date, Raquired onsite,Canstruction P[ans,Stormwater Plans w!SNt Fe�installed, <br /> Sanikary-Padlitles!i 1 dumpster,Si#e Woric Permit for subdivisions/large proJects <br /> CC?MME tA�. Attach{3)complete sets af Hultding P#ans piu9 a i.ife Safety Page;(1}set of Energy Farms.R-O-W Permit for new canshuctlon. <br /> Minimum ten(10)woricing days after submittai date. Required onsi#e,Cqnstructlon Ptans,Stormwater Pians wf SNt Fem:e Instailed, <br /> Sanftary Fadlities 81 dumpster.Site Work Permit for all new praJects.Ail commercfai racauirements m+as:mest cempAan.ce <br /> SIt3N PE tT Attach{2�sets of Et�g#n�red PIanB. <br /> •'"'PROPERTY SURVEY required for aii NEW constructlon. <br /> Dts�sction : <br /> Fill o t applicatlon completely. <br /> ONm &Contractnr sign back of application,notarfzed <br /> N a r t'1Q00,a Natice of Commencemerrt is ropulred. {A!C upgradss over STS�} <br /> " Age t(for the conUactor)or Power af Attomey(for the uwner)wauld be sameone with natarized letter firom ovmer audwrizing same <br /> OVER T £OUNTER PERM{TTINt3 {FroM o#Applica�on Qnly} <br /> Reroois If sh(ngles Sawers Service Upgrades A/C Fences(PIoUSurvey/Foatage) <br /> Driv rvaya-Not over Counter if on pubtic roadways..needs ROW <br />