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NEW HOME PERMIT APPLICATION NOT FOR MANUFACTURED OR MODULAR HOMES <br />STJOSEP11 COUNTYCITY OF SOUTH BEND BUILDING DEPARTMENT <br />CONTRACTORS <br />All contractors must be licensed and/or registered with our department. For more information on this go to <br />h ttp:11vvvvw. so u th bendin. go vA a vernme n Ycontent contractor-ficenses-0 <br />BUILDING: Irish CLIS10111 I 1011leS (REQUIRED ON THIS APPLICATION) <br />a The property owner is allowed to list themselves as the contractor <br />ELECTRICAL: JCA Electric (NOT REQUIRED UNTIL APPLICATION FOR ELECTRICAL PERMIT) <br />PLUMBING: <br />Streb & Son PlUnibing <br />HVAC/AC: Gushwa I leating & A/C <br />OTHER: <br />(NOT REQUIRED UNTIL APPLICATION FOR PLUMBING PERMIT) <br />(NOT REQUIRED UNTIL APPLICATION FOR HVAC/AC PERMIT) <br />(NOT REQUIRED UNTIL APPLICATION FOR APPLICABLE PERMIT) <br />• Electrical, HVAC and plumbing work needs to be done by contractors licensed ondlor registered with our deportment. <br />• Property owners who also occupy the property may do their own electric, plumbing, and HVAC upon signing on affidavit assuming the responsibility and <br />committing to residing in the residence for at least a year fallowing permit issuance. <br />• If the property is for sole or rent- registered contractors must perform electric, plumbing, and HVAC work and purchase their own work permits. <br />I certify the above to be a true and accurate to the best of my knowledge. <br />ire 04/03/2020 <br />APPLICANT SIGNATURE DATE <br />Steve Cooreman <br />PRINT NAME <br />Bryan Keve <br />............................. . ...... . .... . . ... — - --r-r-r-r-1-1-1— <br />VERIFY CONTACT <br />IF DIFFERENT THAN APPLICANT <br />Page 12 of 2 <br />bkeve(a,,cooreman.com <br />EMAIL <br />574-229-6659 <br />PHONE <br />