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8'19-78�-0020 Gi��y o�1'��nyrnnl� b-'�CJ1116H(�yaii�,auv�� . � Buiicting L7 parEm�n[ Dai•e R�coivac! � . . u1i��s � . T�laana Ganfiact��orP�rinii�tinc� r�j� ��. -- ��f -i�ht-I-fy-1-f•1-!'1`t-iy'l----- --- --- ------- =----=-- ----- --- - --------------- -----l-{-l-i-hi-1-I ---•---- -1-l-l-1-ITI7 --- ------- -- - --- ------f-t-s-t-t-�-I-i-r Owner's Name �� rtCJ� � Ovirner Phone Numl�er� ' ' I Own�r's Address • Owrter Phon�I�IumI�er�� F�Q Sim�lo T2ttehald�r Name • Owner Phone Nunili�r�� 1=�e Simpl�T'ttleholdvr.�l.cIdr�ss • • � JC?I3 ADDI�.�SS !� �c�•� Z-�. . Y � �- " � � LOT�ft �f� . � SUBDIVIS[ON ' • �iO�yY' %'��4'�!'� . '� P.AR �I.ID�f �c�—�o �(�/�'c�—L3�1CX�C1-" O,f,�/f� . • (qIITAlNED CftOM PROPGRTYTAXNOfiJCCJ V110IiK I�ROPQSGD ' I�IEVI(CONSTR AqL�ALT � S1GN � MOVE Q DGMOUS!-! �. iNSTALL . . � RCP IP PftOPOSGm USC' : . 0 SFI� ' � � CO M �[ OTI-lGC-t . . TYPG QJ=CONSTRUCTION [� L�LOCi�C [� ' f-`R � ' .[� STBGL Q OTI-IGR p�SCR[nT10N OI=WORFC ' �� CG/t f2�� ' ff L.'� � /7d �� l3U1LDING SIZ� ,tf�.- J� �a''� SQ.r00'f'A�E SCJ I-I�IGI-IT �_.+.� � BUlLDIhIC :(� ' �V� VALUA7 ON OI'TOTAL GONSTI3,UCTl01V �(�flL'l ��r � . . (� EL�CTl�1CAL i� , � AM{'S� VlGG � T'ROGR�SS GN�t�GY • � W.I;.G.G. '` �� �[�' ��.un��W� ;(; � � ��ITSE�ut�� � �__. `� � �� . . MCCI-!ANlCAl. � � �}7�-531�4 C� . �G : . ViqLUA (Of�f OC MECI-fAN(CAL,INSTALLAT101�,��,��,�� (� GAS [�] I�OOT=lNG � 5f'-CIA.L."CY � OTf-lGl� ` � S,�g^vt. ClI�!!SI-I�D FLOOI�ELCVATtONS ('L OD ZOItl�Al�.EA �YGS [�i�i0 � i3UfLt�CR �,��,�,, `�� COMPANY �� -'�� , -',�L�C.-_ 51GNATUfiC • �ZGGiSTCRED Y/ N FGE GURRL-NT Y 1 N ' Addr�ss (�/.r�f j� �-t}� � - • . lJcense�! 1 X (k>b01`l f T � G�GCTI�ICIAN _ ("''� � - � .� CQMPAN'Y �!T/ Y-e�r ��Cy�' SI�NA.TUT�tG �� r��ts7cr�to 'Y! N r-cc cuuRtN'r Y/N Acictr�s� � - � .�'jl1.X /cS-3� hi� l.l • �.ic�nse� ("� —.� 1 PI.UMR�R . � GOIU(PANY sI�NATURC c�cczsreRep v� tv. -r-s�cunr�cNr Y/N . Aciclr�ss Licenso�1� � � � l+11�G1•!ANlGAL � ' • ' GOMI�:ANY � SlGNATUI�� • r��c�sYCrtea Y 1 N 'r-r-..�curtt�ctvr Y/N . Addr�ss - • .License�t� �� i � OTi-tCi� . ' , COMI�ANY . .• . SiGNATUl�G r�cts'rcrt�� ' Y/ N r-e�cut�r�ct�r Y t N Address , L.icense�f � � • T[-TI�l�TI1=FF!- -- ---- ------ ------------- RC5ID�NT(AI. A�fmch(2)Plot Ptans;(2)s�ts ofi Buif�iing f'fans;(�I)s t of Et��r�y Forms;l�-o-W i�ermI[ior n�w constcuo�ion, Minimum fien(90)working d�ys after submilla!dalo. {�equir�d on�ifi�,Gons[ruc�ion I�Jans;Sinrmwator Pfans w/Silt f ence tnsta!lecJ, Sanitary 1=acilitlos&1 clumhs�er;Siie Worlt Permlt fo subdivisions!larc�e�raj�c[s . COMMCt�CiAL: Attacli{3)complet�sats af IIuI[ding P[ans�Ius a LIfi Safoty t�ac�a;(1)set ot Cn�rc�y.'Forms,l�-O-W PcrmIt for nev✓consiructian. Nifnimum 1en(�f 0)warl4in�clays afC�r sui�mitEa(clate. i��quired onsite,Gonsfiruotion 1'Ians,Siormwator nlans wl Sltt f'ence inskallecl, sanitary 1=acififi�s i�'i c3rsmpster.Sito Worfc Permlt�[a a!!new�rrojecis.Alt commorciai r�quiroments mus[meet oomplf�nae ' SIGN PGRMiT Attaci�t2)sets of�ngin�ared Plans. ""''""�PROP�I�TY SURV�'raquirocl•far aiI NCW cons rucfiion. � • ' -i-t-f-t-l-f-t,-l-(-t-l-I-l-l-l-3-i-1-l-1-l-F2-1-ld-1-1-I-l-l-l-l-Id-1-1-I-I-I-id-I-Id-l-I-Id-FI-1-t-I-I-t-1-I-i-I-I-i-i-I-I-i-t-i-i�i-i-i-I-t-t-I 1-l-l-3-l-t-1-I-1-I-1-l-1-I-3-1-I-1-1-l-l-kl 1-1-l-I-1-1-I-1-1-1-l-1-1-1-[-1-1-I-i-I-i-i-f-i-i-i-I-I-i-t-1-I-1-I-I-i-FFi-t-t-E-t-FFt-1 t�froc[ions: FII)ou!a(�pllc�tion completeiy. � . Ownor&Cantractar stc�n vacit of appfication,no[arizac( ' • Ir over�2�Q0,a Nofiice o�f Gomm�ilc�m�:zt is roc�ulred. (AIG upg acIes ov�r�50Q0) `"" A�enG(i'or the co,ntractor)or 3'owor of AfEorr�oy(Por ii�c�own�r)wou(d e som�on�wItlz notarized lotter•fram owner authorizinc�samo - •oV�R Ti•IG COUNTCI�I'zi�MITT(�IG �rronl of App{icaition Only) • Paroofs ' Sowers Sotvice.Uj�graclos AlC Penc�s{PfoitSUiveyJCoofiage) . �3riveways-Nol'over Counter Ifi on puUlic roaciways::n��ds i�OW