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<br /> 813-/tlU-UU'GU l�ll,�/ VI C���y���m�u � a.�nu�,•rr�,•••,•,.,.•'-
<br /> Buitd(ng Department �
<br /> Date Received � �( ? c�
<br /> hane Carttaet far Ferinitting �3 7�? � �� !_� ;;
<br /> owiser's�Ha�ine _. fi��l t5�0�(� � ��c�� "�- �(�C�� ��
<br /> . ._......._..: Clwner Phoae Nuriiber !s> _ 't t� !
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<br /> Owner's�Addiess ��Z� C_F/�v`C� / �`+�— Owne�Phane Number
<br /> _ ., � �',
<br /> Fee Simple Titleholder�Name I Owner Phone Number�- �!;
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<br /> Fee Simple TitlehalderAddress � •
<br /> JOB.ADDRESS: ���''� C.Gc^r'Gtfi" �¢' �'t �'h(i��S� T�-- �3�'J�2^ L.OT#
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<br /> _ _su��i�v_isrorr' �tt.s �'�5 . ;,;PARCEL=;lD� :'I3:°'2.�—2i-- D I.zb--���--.d�7t� . .
<br /> � ' �" ' � - =-_ --(OBTAINED-FROM PROPERTY TAX NOTICE)_
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<br /> WOFtMC PitOPOSEp� e iVEW Ct7NSTR ADDlAL'i' StGN MOVE Q DEIVtOL(SFi
<br /> � � � ' ��� ` `"'�' � � INSTALL REPA�Ft � _
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<br /> PRt)POSED U5E . Q SFR'� GQMM `���OTHEff �' . ` " • • '
<br /> TYPE OF CONSTRUCTION ,�✓�. BLOCK _,, FRAM6 Q STEEL � Q OTHER ' - � � �
<br /> DESGRIPTIONtOF;INORK},' It,a,ii�'i3��i'fC"'f�' `�� '���� ) �f d fdb� j�UG( �5c$•;,.�tm'�' t�{�'.C,�G. .C`--��I.C� ,
<br /> I BUlLDING,SfZE �� ., :_SQ FOOTA �E.1_. � _� NEI�,FtF��_� � �
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<br /> , � BLlIi.DING . � .. � 1 t, � VAE.Cl�TiU{V OF TC)TAL Gt�NSTi2U.CTItiN � . ' ' . ,. '
<br /> � ��`{;�`:��. .'.•`� . . -
<br /> Q �LECTRICAC � � AMP SERVIGE Q PF20GRESS E1�iERGY Q W.R.E.G.
<br /> Q P�EJMBING � � . � ..
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<br /> Q �MEGHANlCAL $ z , _ VAl.UATION OF MECtiANtCAL INSTALIAT[Ot1 • ���� �
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<br /> � o,as �:� t�oo���� s��c�aLrr j� ort��R � " �
<br /> FINISWED F1.00R ELEVA710NS FLOOD ZONE AREA QYES [�NO , .
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<br /> . BUI[.DEi3_ �_.. _,. _. __----- _ _. CQMPAI�IY ...:. . , . .
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<br /> SIGNATURE . . ,RE��s7ert�o Y/.N . FEE CURREN'f �� `Y/IV ' - ° " I
<br /> Address � ' ,Lficense# '� .` ' ' � ' ( (
<br /> . �
<br /> ELECTRICtAN CUMPANY � � ' - `
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRENT' ''Y/N
<br /> Address � License#�"�� ' �
<br /> PLUMBER CCIMPANY
<br /> SIGNATURE � R��ISrER�D Y/ N �e cU�Nr Y!N
<br /> Address I Ltcense#� � - -- �
<br /> M6CHANICA� COMPANY' � � • '
<br /> SIGNATURE �R��is�REa � � Y! N �e cuRR�Nr Y!N
<br /> Address ` ' - ' �I Llcense# - � ' 1
<br /> OTHER:° ��.� =.Ct}MPANY..::� �"� ��b-F�h ' ��Xt4 , . ` .
<br /> SIGNATURE�� RE�.,ISTER�O Y IV FEE CURRENT' Y 'R)
<br /> ;Attilress=.; ,�tv�t3 �' � t r'�?r��5 F� 35�� � . �`License� 1��%�./�`ZS���
<br /> RESlpENTlAE. Attach{2}Pta#Pians;{2}sets af Buiiding PIa s;{1j set�of Energy Forms;R-0=W Perm(t for nevu construcUon,
<br /> � Minimum fen(10)..working:days after submitt i date. Required onsife,ConstrucNon Piaas,Stormwater Plans w!Si1f Fence iristalled;
<br /> � Sanitai.ry Feciltties 8�1 dumps#er;,Site Work �ermit fbr subdivisionsllarge proJects " �
<br /> GOMMERCIAL Attach(3}_sets af�Building Pians;(1)set af E ergy Forrris:12=0-W..Permif farnew construcNnn. ; : . ' .
<br /> Minimum ten�(10j wotking days affer submi## I date. �Requtred onsite,Constructian Pfans,Sformwafer Plans.w!Silf Fence instaJisd,
<br /> Sanitary Facllitles&1'dumpster.Site VVork ermlf for all new proJeots.Al)�ommercial requirements must meet compliance` � - ,
<br /> SIGN PERMIT Athach(2}sets of Engineered Plans. ` . , '
<br /> "*"PROPERIY SURVEY requtred.for all N6 construcUan. . .
<br /> Directlons: .
<br /> Fill out application compiefety. � ' , � ,_ �
<br /> Owner&Contractor sign back of applicaUon,notarized
<br /> If over$2500,a Notice af Gommencement is requlred. ( C upgrades over$5000} •
<br /> •' Agent(for the aantractoc)or.Powec of Attomey.(for the.owner would be someone wikh notarized lette��from'owne�;authorizing'sam'e°';" '
<br /> 'QYERTHEGOt}t�iTERPERMlTfING (Ftnnt�of�App�icaUon�Otil j'; „ ;,r:� ` _., .. " . . �
<br /> Reroofs Sewers �Serviae;Upgrades ,AJ '� Fences(P1otJSurveyJFootage) ,t" ,:;; � . � ' - --.
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<br /> priveways-Not over Cciuriter,if,on.puii.lic roaii,ways..ne_e:ils R� Vii _ , .. ...u._..�.......,._ F..,,...,�.,,..,,,,.
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