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uflding Department <br /> : ,r+a��-en <br /> Date Recelved � <br /> ' 2Z:�� Phone.Con act tor.Permittin /3 Z��l - ��16� <br /> Owner's Name �6 P1��NCQ 0��ft7'c r�l Owner Phone Numba �'i 3 -7�2 -2`�3�i <br /> Owner's Address S�0'�e' Owner Phone Numbe <br /> Fee Slmple Titleholder Name Owner Phone Numbe <br /> Fee Simple Titleholder Addreas � <br /> JOB ADDRESS ����'3 �� �'� Z�'�'� �`�i/� dCL 3 3 Sy 2 LOT# C f�f�/ <br /> SUBDIVISION �'�y �'� 22,Pheayh� //S P �RCEL ID# 1� -2v '2f -�p i� ctis'vc�@ - pCa9Q <br /> (OBTAINED FROM PR PERTY TAX NOTIGE) <br /> WORK.PROPOSED e NEW CONSTR B A �D/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL R PAIR <br /> PROPOSED.USE Q SFR Q C_ MM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME [� STEEL Q <br /> DESCRIPTION OF WORK' �2Mov2 C�R�� �-iN�t , L '-�SiA li R6'P�a� C�� �rl L �� ��� GL <br /> �t e� 5 r�-r�5 <br /> BUILDINt3 SIZE SQ FOOTACiE HEIGHT <br /> Q'61�ILDINO $` VALU TION OF TOTAL CONSTRUCTION <br /> `2 D/i� . 2 i� <br /> QELECTRICAL $ AMP ERVICE Q PROO ESS ENERGY [� W.R,E.C. <br /> OPLUMBING $ <br /> �/���Z <br /> QMECHANICAL $ VALU TION OF MECHANICAL.INSTALLATI.ON <br /> OGAS Q ROOFING Q S ECIALTY C] OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> G C��� 12.,Z'� <br /> BUILDER COMPANY (-aw•eS ldoM�e, CeNT�2s ' �-f-� <br /> S(GNATURE . REGISTERED Y/ N FE CURRE� Y/N <br /> Address O QO� � ��J ��A �`" 3�"��� Licens # ��o�, .S C� � � <br /> ELECTRICIAN ' COMPANY <br /> SIGNATURE REGISTERED Y/ N FE CURRE� Y/N <br /> Address Licens # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FE CURREA Y/N <br /> Address Licens # <br /> MECHANlCAL. � COMPANY <br /> SIGNATURE REGISTERED Y/ N FE CUItRE� Y/N <br /> Add�ess Ucens # <br /> OTHER COMPANY <br /> SIGNATURE � Rec31sTERep Y/ N FE CURRE� Y/N <br /> Address Lfcens # <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Build(ng Plans;(1)set of Energy Forms;R-O-W Pertnit for ew constructlon, <br /> Mlnimum ten(10)working days after submittal ate. Requlred onsite,ConstrucUon.Plans, tormwater Plans w/Silt Fence installed, <br /> Sanitary�Facilltles&1 dumpster;Site Work Pe it;for subdivlslons/large projects <br /> CC�AfIiNERCIA-�—A acti-(3)compleie-seCs-of Bufidiny-f'lans piu� �tife Safety�aga;(1).•et os E���rgy-Fo�ms:R-O:N-P-ersn!t-for-n�w-constructton. _ _ __ _ <br /> Minlmum ten(10)working days after submittal ate. Required onsite,ConstrucUon Plans, tormwater Plans w/Sllt Fence installed, <br /> Sanitary Faciiitles 81 dumpster.Site Work Pe It�for all new proJects.All commercial requi ements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '•••PROPERTY SURVEY requlred for all NEW nstruction. <br /> Directions: <br /> Ffll out appiicatlon completely, <br /> Owner&Contractor sign back of applfcation,notarized <br /> If over S2500,a Notice of Commencement Is required. ( C upgrades over ST500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth notarized letter fro owner autho�izing same <br /> OVER THE COUNTER PERMITTING (Front of Appllcation 0 ly) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter If on public roadways..needs.R W� <br />