Fillable TOWN OF SUPERIOR SOLAR/MPE PERMIT 199 N LOBB (Town of Superior)

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TOWN OF SUPERIOR SOLAR/MPE PERMIT 199 N LOBB (Town of Superior)

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  • 11 check-boxes
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Country of origin: US
File type: PDF

U.S.A. forms for Town of Superior

BROWSE TOWN OF SUPERIOR (AZ) FORMS

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TYPE OF APPLICATION: COMMERCIAL MECH PLUMB ELEC SOLAR
PARCEL
STREET ADDRESS: CITY/STATE/ZIP
PROPERTY OWNER (S) ADDRESS
CITY/STATE/ZIP PHONE#
RENTER/TENANT (S) ADDRESS
CITY/STATE/ZIP PHONE#
CONTRACTOR ADDRESS
CITY/STATE/ZIP PHONE
LICENSE/CLASS#
CLASS OF WORK: (Check one:) NEW (or) REPAIR
# OF AMPS _
# OF BTU’S
SIZE OF PIPE
TYPE OF PIPE
LENGTH OF RUN
# OF KW (PHOTOVOLTAIC SYSTEMS)
Type of system; check one: Roof Mount Ground Mount
#OF LIGHTS TOTAL LUMENS MAX HEIGHT
UTILITY COMPANY (check one):
SWG other specify APS
WELL REGISTRATION# (If applicable)
EXISTINGUSE:
PROPOSED USE:
CONTACT PERSON (WHO DO WE CONTACT WHEN PERMIT IS READY FOR PICKUP AND/OR QUESTIONS?):
NAME PHONE
EMAIL
I UNDERSTAND THAT APPROVAL OF THIS APPLICATION DOES NOT GUARANTEE APPROVAL OF THE ACTUAL CONSTRUCTION. I HEREBY
CERTIFY THAT THE INFORMATION ON THIS APPLICATION AND ALL RELATED SUBMITTALS ARE TRUE AND CORRECT.
PRINT NAME PLEASE SIGNATURE OF OWNER/ AGENT DATE OF APPLICATION
TOWN OF SUPERIOR
199 N LOBB AVE, SUPERIOR, AZ 85173/520-689-5752
SOLAR/MPE PERMIT
*****************************FOR OFFICE USE ONLY******************************
PERMIT FEE:_________________
PLAN REVIEW FEE:___________
INSPECTION FEE:______________
ADDRESSIGN FEE:______________
ECD:_________________
SUBMITTAL FEE: ______________
ZONING FEE:___________________
PRINTING/MISC FEE:____________
TOTAL FEE:____________________
Permit :
Date:
ZO
N
ING :_________________________
NON-CONF:________________________
ACT. VALUATION:_________________
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199 N Lobb Ave, Superior, AZ 85173 T 520-689-5752
www.superioraz.gov
PROPERTY OWNER AUTHORIZATION FORM
I (property owner)
hereby authorize (owner’s agent)
To make application to Town of Superior for the following (description of work)
Assessor Parcel Number:
PhysicalAddress:
City/Town: State: AZ Zip:
By signing this Form, I acknowledge and agree that I am not released from
responsibility for: (1) the payment of any and all fees associated with the issuance
of any permits, orders, notices or other approvals (“Approvals”) by Town of
Superior pursuant to my agent’s application; (2) the satisfactory completion of all
work authorized by such Approvals in compliance with all applicable county, state
and federal laws, codes, rules, regulations and requirements; and (3) correcting
any violations of the terms and conditions of such Approvals issued by Town of
Superior pursuant to my agent’s application.
Property Owner:
By (signature):
Name:
Phone Number:
Email:
Date:
TOWN OF SUPERIOR
199 N Lobb Ave, Superior, AZ 85173
520-689-5752
(Incomplete applications will not be accepted)
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TOWN OF SUPERIOR SOLARMPE PERMIT 199 N LOBB (Town of Superior)

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Completed 24 January 2021

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