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IFOR 6'F~i~E USE ONLY[ <br /> <br /> Zoning Validation: __ ~ I <br /> <br /> COMPLETE ALL SECTIONS, 1 T~OUGH 4 <br /> L job Description <br /> <br /> COMMERCIAL ( ) New <br /> <br /> ( )Relo~tiorl ( )Addition ( )Sign <br />( > Alteration ( )Demolition ( )Alteration ( )Demolition <br />( ) Aeeeasol5, ( )Other ( )Chang¢ofOccupancy <br /> <br />Desedpdon of Wo&: ~----~ <br />Tmaa ( ) or Rafter ( ) ] No, Stories <br /> <br />Use of Stroctum; <br /> <br />Occupant Load ov Nt~mbet of la <br /> <br />Square Feet: Basem~t: t Main Floor: Seo~nd Fl~or; I Other: Height: <br /> <br />2. Location of Installation <br /> <br />pmpertyOwner ~c~_ ~\ k ~-~, [ Mai~gAddmss Ph~eNo, <br /> L <br />Mob~e/fOtne Pa~ S~ g <br />' Pdvat~Well ( ) Spring <br />Lo*Width 10~ L~D~pth [~/ Acm~ Img,~t ~ Comer ~ Commtl~;y~( <br /> <br />3. Co'mlrhctor Information <br /> <br />Property Owner :l Mailiog Add.ss I Phone No; <br /> ( ) I own, reside in, or will rcslde ill the completed structure. <br /> <br /> ( ) I imflerstand that I must ~glstet as a construction contractor if the structure is sold or offered for sale before or upon completion. <br /> ( ) I will be my own general contractor, <br /> <br /> ( ) I am a res stared bu Ider OR th~ authorized rel~sentativ~ of a mglstemd builder, : · , , , <br />Architect name: ] Mailing Address: J Phone:' <br /> <br />4. Fee Schedule <br /> <br />A. VALUATION (See "Valuation Schedule" <br /> <br /> square footage.) <br /> <br /> (1) Pemtit Fee <br /> <br /> (2) 5% SIat¢ Surcharge (.05 x Al) <br /> (3) Structural Plan Review (,65% X Al) <br /> (4) Pim & Life SaCety Plan Review (.40% x Al) <br />.~: (5) 7x>nin Surcharge il' applicable (,05% x A I ) <br /> <br />l.tt <br /> <br />(1) Driveway w/cu~ @ $7,50 = __ ..... <br />(2) Ddvewayw/oeurb@ $17.00 : ..... <br />(3) Site Plan Review (commercial only) @ $79.00 <br />(4) Additional Plan Reviews or Addendums <br />(5) ]Investigation Fee <br />(6) Reinspaetion Fee @ $25.00 ~ = <br /> <br /> <br />