SAYRE CODE ENFORCEMENT AGENCY BUILDING PERMIT. APPLICATION  MEMBER ICG NIERNAIHONAL CODEC COUNCIL  TNssertlions siobccipleted An4.p pail Dale tecesed Kecevalky  HOV W. Packer Ave Sayre, PA 18840 570-88-888-410FAX570-88-6598 lylheCoieorce  MEMUER  PROJECTED START DATE: PROPERTY OWNER'S NAME: STREET ADDRESS FORI PERMIT: Single family Residential or Commercial OWNERSTELEPIONE (home#): SEWER:  TOTAL COST OR VALUE OF PROJECTS  Multi-family Residential Miut-amiyRuidemta,  #of Units  Commercial/with residentinl units  #ofUnits  IrMulti-family with more than 2 units, property is considered Commercial  (work#): (well)  (cell#)  (public) (scptic). (#ofEDU'S)  WATER:  (public) HEATING SYSTEM IS:  (hotair) (electric) (hot water)  CONTRACTOR INFORMATION- - List all contractor's doing work- Ifyou arc using more than one contractor, please list the work to be performed by each contractor: *Ifproperty owneri is doing their own work, see exemption.  ROJECTDESCHIPTON: (please explain in detail) Remember-if: you are digging calll PA-ONE CALL (811).  IFDRIVEWAY - PENN-DOT APPROVAL:  BOROUGH APPROVAL:  PROJECTSKETCH  NOTE: Theowner must verily allp pruperty lines. Rtist thes responsibillty: ofihe owher: and thes cuairaclerlo khuw anda adhere to all Felevant codes and urdinances. Questions should bes directedto the Code Ollceat 571-158-4410.  INCLUDE ALLE BUILDINGS. SET BACKS. MEASUREMENTS. ETC.  EXEMPTION FROM WORKER's COMPENSATIONI INEURANCE:lfpropany. ovner slates ahatl they are doing thcire own work, by signing this THIS PORTION TO BE COMPLETED! BY CODE ENFORCEMENT OFFICE: Sidewalk Check- Sitel Inspection Pass Fail  application thie property owner: allirms that they will not hire ny employce (vontractur) to werk on the projec,  APPLICANT'S: SIGNATURE, Date received: Permit Number: Date Approved: Denied: Reason for denial:  DATE  hairatiegesex  Project cost: Permit Feet Date of final inspection: Initials ofi inspector:  CODE OFFICERSSIGNATURE FOR APPROVAL:  DONTFORGETTOCALLBI1ORII-S00-242-1776) PAONE CALL BEFORE YOUDIG.