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_._ _______ �t�y or Gepnym��ES rermRt App4iCation F�x-B13-?80-0021 <br /> Buf{dfng Department ^�r>������ � „�� ��r <br /> �7 <br /> Dats Receiv�d ' — '� ��� <br /> Phone Contact for PermlEtin � <br /> Dume�'s Nama 1 Owner Phone Number ''P <br /> Dwner's Address � �-� ) Owner Phone Number � ~ � �� ` j <br /> J <br /> Fee Sfmple'Fltteholder Name Owner Phon�tdumber <br /> Fee Slmple Tltteholder Addness <br /> JOB ADDRESS LOT# � <br /> SUBDtViSiON � ���C}c.t.� PARCEL'Ib# ' <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PIROPQSED e NEW CQNSFR 8 AODIAl.T [� SIGN [�] Q DEMOI.tSH <br /> Ii+tSTAIL REPAIFt <br /> PROPOSED USE � SFR [� COMM � 07HER <br /> TYPE QF Ci?NS'TRUCTlON Q B�OCK Ff2AME � STEEL [„� <br /> DESCRIPTION OF WORK .L I�S T A L C. <br /> BUlRDINl3 SlZE • SQ FOQTAGEC�,-� IiEiGHT � .I� <br /> QBUILDING $ ��_��� VRLUATION OF TOTAL CONSTRUCTiON <br /> �"•_..1 <br /> [�ELECfiRICAI $ AMP SEFtVICE Q PROGRESS ENE�tGY . . .C. <br /> C �- � <br /> QPLt1MBING �� ,���� <br /> � <br /> [�MECHANtCAl. �� VALUATiON QF MECHANtCAt INSTALWTI N <br /> i <br /> _ [�GAS [„� ROQFING Q SpECtAL'iY � OTNER � C� C'�E E��� <br /> -1NISHED FLOOR ELEVATIONS F�OQD ZQNE AREA [�YES i�t0 P�}�.�" j�,�� <br /> � ��� ��� <br /> I <br /> 3UILDER ,� ,.r,.1=^�' � COMPANY � V r,� M.CC K..J <br /> 31GNATURE �� REGlSTEREQ Y/ N FEE CURRE� Y!N <br /> A�ldress Clcense# ��� ��l�)ty`� � <br /> 3�ECTRtC1AN COMPANY �I Gt C21 � rtJ <br /> �tGNA7URE REGISTEREQ Y/ N FEE CURRER Y J(V <br /> Address License# �� � <br /> �i.UMBER � COMPANY , <br /> iiGNA'NRE ( REGISTERED Y/ N FEE CURREt� Y i N <br /> Address License# �' � <br /> AECHANICAI. COMPAMf <br /> flGNA7URE REGiSTEREO Y! N FEE CURRE� Y!N <br /> Address license# � � � <br /> )THER � COMPANY <br /> �IGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> addr8sg Ucense# �� ��—, <br /> tESIDENTtAL Attach(2�.Plot Plans;{2)sets,of Building Plans;(1}set of Energy Farms;R-O-W Permit for new construction, <br /> Mlnimum ten(10a.working ilays after submittal.dake. Requlred onsite,.Cottstructfon Pians,Stormwater Plans wi Sitt Pence inst�lled, <br /> 5anitary Facllities&1 dumpster,,Site Work Permit(or subdivislonsAarge pro}ects _ <br /> :OMMERCIAL Attach{3)complete seks ot 9uilding plans plus a LJfe Safety Paga;(1)set of Energy Forms.R-O-W Permi#for new constructlon. <br /> Mlnimum ten{10}working tlays after submlttal date. Rsqufred onsite,Construction Ptans,5tortnwater Plans w/Silf Fence tnshalled, <br /> Sanitary Faclllt#es 8�1 dumpster.S(te Work Permft tor aft new projects.Aii commerotat requirernents must meet compliance <br /> �IGN PEFtMIT � Attacti(2j sets of Englneered=Plans. � ----- - _- <br /> `""PROPERTY SURVEY requfred'far al!NEW canstrcacBon. <br /> iirecHana: <br /> Fill out appllcaUon completely. <br /> Ovmer&Gontractar sign back of appifcatlon,notadzed <br /> If aver�2500,a Mottce ot Commencement Is requlr�:d. (AIG upgrades over��500) <br /> ' Agent{for the cantractor}or Pawer of Attomey(for the owner)would be someone vuith nokarized letter from owner authodzfng same <br /> 1VER TNE COUNTER PERMITTING (Front of AppNcatlon Oniy) <br /> ;eroats if shinglss Sewers Setvice Upgrades NC Fences{PiodSurveylFootage) <br /> Drlveways-Nat over Counter if an pubtia roadways..needs ROW <br />