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�„-,�„-„��� t;�ty ot[e.pnyrniits Permit Application Fax 8i3-780-0421 <br /> Building Department <br /> .te Recsived Phone Contact for Permittin — <br /> xner's Name ��f`�-t�� �/����^ Owner Phona Numbar <br /> rner's Address ��J�2-- � ��b`"�"l J �d/'`-'"' O�vn�r Phone Number � <br /> e Simpie Titiehotder Name �� � Owner Phone Numbor <br /> e Simple Tltlehoider Address <br /> �B ADDRESS LOT# �__� <br /> �so�vrs�oN �'L�d�� �`G�-L�!�'� Pa�cELti�# �S-�...5"�-�1--���P9��'�dG��1�� <br /> (OHTAINED FROM PROPERTY TAX MOTICE) <br /> �RK PROPOSED e NEw CONSTR 8 ADDIALT [� StGfV o c.� DEMOLISH <br /> iNSTALL REPAtR <br /> :OP05ED USE Q SFR Q COMM � QTHER <br /> P�OF CONSTRUCTiON [� BLOCK Q PRAME [� STEEL Q <br /> :scR�Q�axo�waRK C� /L���' �.-`� 1��;� 3p' t.S"/r�f�i1�-r,..�f <br /> �I�DING SIZE �` � SQ FOOTAGE C,�� HEIGHT ��� <br /> QBUt�DING � . .y �Q . VALUATtON OF TOTAL CONSTRUCfi1QN <br /> +t.d <br /> �]ELECTRICAL $ yi� AMP 5ERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMSING ��� <br /> C]MECHANICAL � � VALUATION OF MECHANICAL INSTALLATION <br /> [�GAS 6[�� ROOFING [� SPECIALTY � OTHER <br /> IISHED FLOOR E�EVATtONS (�� F�OOD ZONE AREA QYES NO <br /> � <br /> !l.DER � COVYIPANY <br /> 4NATURE REGISTEREb Y I N FEE CURRER Y I IV <br /> Address Llcense# � � <br /> ECTRICIAN � _ ° � COMPANY <br /> �NATURE REGI5TERE0 Y/ N FEE CURRER Y J N <br /> Address LEcense# �- � <br /> 1MBER � � COMPANY <br /> �NATURB REGISTEFtEO Y 1 N FEE CURREh Y J N <br /> Addrsss License# � � <br /> CHANICAI. COMPANY <br /> NATURE �G�S�o Y 1 N FEE CURREF Y J N <br /> Addre�s license# �� � <br /> �ER ��,r/�� � COMPANY G`�/��1� /U1�''`�/�� <br /> NATURE Rs��s���a Y 1 N ' F�CUt��s� Y 1 N <br /> Addre�s � ��1�-- l+�� �ft�L�c/z Ucense# l�-C�OZ���� � <br /> i1DENTIAt. Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construcdon, <br /> Mfnimum ten{10}working days after sUbmittai date. Requt�ed ansite,Cor�struc�on Pians,Stormwa#er Plans wJ Sllt Fence Ins#ailed, <br /> Sanitary FacillUes&1 dumpster,Site Work Perrnit for subdivislons/large proJects � <br /> AMERCIAL Attach(3)complete sets of Bullding Plans plus a Life Safety Page;(1)set of Energy Fonns.R-O-W Permit for new constructlon. -- - <br /> Mintmum ten{10)warking days after submittal date._12equired-ansite,Conshuction Pians,Storrnwater Pians wl Silt Fence instaileci, � <br /> Santtary Facilities&i dumpster.Site Work Permit for ali new projects.All commercia�requirernents must meet complience <br /> N PERMMT Attach(2)sets of Englneered Plans. � <br /> **"'PROPERTY SURVEY required far al!NEW canstnictian. <br /> ctlons: . <br /> Fiii aut appfication completely. <br /> Owner&Contractor sign back of appifcation,notarized <br /> If over�2500,a Notice of Commenc�ment i�requir�d.� (AIC upgrades over�75d0j <br /> Agent(far ttre contractor}or Pawer of Attamey(for the owner)would be someone wifh notarized letter from owner authorizing same <br /> ;R THE COUMTER PERMI7TING (Front of Applicatlon Only) <br /> �afs tf shingles Sewers Se�vice Upgrades AiC Fences(PIatlSurveylFaotage) <br /> Driveways-Nok aver Caunter if an publlc roadways..needs ROW <br />