WELLSVILLE BOROUGH Parcel No. Permit No. Case No. BUILDING PERMIT APPLICATION Commercial Residential PROPERTY. ADDRESS: City: State: Zip Code: CURRENT USE OF PROPERTY: APPLICANT'S NAME: (SHALL be a persons name) ADDRESS: City: PHONE #: OWNER'S NAME: ADDRESS: City: PHONE #: State: FAX#: Zip Code: Email: State: FAX#: Zip Code: Email: NOTE: Permit Applications must be accompanied bya ai fully dimensioned and scaled plot plan,completed supplemental applications and detailed construction drawings, (twos sets). Type of Improvement: Proposed Use: New Building Addition Alteration Repair, Replacement Demolition Moving (relocation) Foundation Only Sign - Lighted Sign- Unlighted Single Family Two Family/Duplex Detached Garage Attached Garage Carport Pool/Hot tub Deck/Patio Other-S Specify DESCRIPTION OF WORK: COST OF IMPROVEMENT $ General Contractor Business Name Contact Name Address City Fax Telephone Email Zip State Mobile Architect/Engineer Business Name Contact Name Address City Fax Telephone Email Zip State Mobile Indicate who should be contacted if there are questions during the review process Applicant Owner Architect/Engineer The undersigned agrees to conform to all applicable laws of this jurisdiction. The issuance of this permit does not relieve the owners, or any other person or persons in possession or control of the building, or any part thereof, lawi for the uses or purposes for which the land or building is designed or intended, nor from complying with any lawful orderi issued with the object ofr maintaining the building or land in a safe or lawful condition, nor from regulations specified by any homeowners' association. Permit is subject to possible appeal by any party fora a period of 30 days after issuance. Permit may expire if work described therein has not begun within 6 months afteri issuance or if work lapses with no activity for a period of 61 months. Wrecking permits require owner's from obtaining such other permit or licenses as may be prescribed by complying from any regulations specifiedi inj property deed restrictions or signature. Applicant's! Signature Applicant's Name (Printed) Application Date BUILDING CONSTRUCTION, AND SAFEIVSTANDARDS regulated by the Uniform Construction Code. Work to construct, enlarge, alter, repair, move, demolish, or change the occupancy ofas structure, or to erect, install, enlarge, alter, repair, remove, convert or replace any electrical, gas, mechanical, or plumbing system