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�-- <br /> ts'io=rtsu=�uzu --- ! l;li�/ OT Lepfly�f1111S f�'effllli HpPllqilOfl rax-a�i�-inu-wc i <br /> _: ` • � Building_Department <br /> ' � I'1'� a'��i <br /> Date Received . <br /> � 2 �� PMone.Contact for Permlttin �ti� ��`� --�! fo� <br /> Owne�'s Name �(�� � l.�;O rv►,IPTpc� Owner Phone Number ��3 — 1 �3 � 1�i <br /> Owner's Address �Z� ��Mti� ,9^' 70� ��2 � Owner Phone Number <br /> �� <br /> Fee Simple Titleholder Name C_ Owner Phone Number ' <br />' � <br />� Fee Simple Tttleholder Address <br /> JOB ADDRESS �O�(7 �`�_TnT�'d�9 i o a.l �2 Z2�I�YL►i!�5 IcL;���`�/2 LOT# <br /> � <br /> SUBDIVISION ] PARCEL ID# <br /> i (OBTAINED FROM PROPERTY TAX NOTIGE) <br /> WORK PROP03ED NEW CONSTR ADD/ALT Q 51GN Q Q DEMOLISH <br /> INS�ALL � REPAIR <br /> PROPOSED.USE Q SFR �] COMM �] OTHER , <br /> TYPE OF CONSTRUCTION Q BLO�K L] FRAME 0 STEEL Q � <br /> DESCRIPTION OF WORK 1�Y��}� �C9 p 2, c,�,av�TS S�Ze-�S;Ze. �l- � S 2-Z 5 F� �a..��9 <br /> � <br /> BUILDING SIZE � SQ FOOI'AGE� HEIGHT <br /> BUILDING $ r �� . � VALUi TION OF TOTAL CONSTRUCTION <br /> IO . <br /> QELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY Q W.R,E.C. <br /> .� <br /> QPLUMBING $ I I I ��E��3� �1' <br /> C,-� . t � �``�- <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � U <br /> C'� � �° \� <br /> QGAS Q IROOFING � SPECIALTY Q OTHER � ���� �� <br /> � s,� <br /> FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA QYES NO <br /> �; f'- �� G �-�.� �..�:� <br /> . - ; ; �,�� l <br /> �� BUILDER j I COMPAWY C.���-eS l�oM�� CeNT�2� �- <br /> SIGNATURE I �" REGISTERED Y/ N FEE CURRE� �Y/ <br /> Address �Qo C3ou '� �1 °i � �'�A���' � 3�-��� Llcense# C�F�G .5'� � 1 <br /> � <br /> ELECTRICIAN I COMPANY <br /> i SIGNATURE i REGISTERED Y/ N FEE CURRE� Y/N <br /> I <br /> Address � � � License# <br /> PLUMBER I� LOMPANY <br /> SIGNATURE I REGISTERED Y/ N FEE CURRE� Y/N <br /> Address i I � License# � <br /> �-T <br /> I <br /> MECHANICAL � I;OMPAPIY <br /> SIGNATURE � i REGISTERED Y! N FEE CUFtRE� Y/N <br /> � � <br /> Address � � � Ucense# r I <br /> OTHER , COMPAWY , <br /> 81GNATURE I I REGISTERED Y/ N FEE CURREA Y I N <br /> Address I � Ltcense# � <br /> tii�Miiittii�Ffii ' I <br /> RESIDENTIAL Attach(2)Plot Pfans;(2�sets of Buliding Plans;(1)set of Energy Forms;R-O-W Permit for new construcUon, <br /> Minimum ten(10)worfcir�g da�s after submittal date. Required onsite,ConsVuctlon Plans,Stormwater Plans w/�Siit Fence Installed, <br /> Sanitary-F,ac111Ues&1 dumps�er,Site Work Permit for subdfvlslonsAarge projects _j <br /> COMMERCIAL Attach(3)complete set�of Building Plans plus a�Life Safefy Page;(1)set of Energy Forms.R-O-W Permit-for new consUuction.�—=-�1�— I <br /> Minimum ten(10)workir�g da�ys after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w!Sflt Fence installed, I <br /> Sanitary Facilitles 8 1 de�mps er.Site Work Permit for all new proJects.All commerc(al requirements must meet compilance <br /> SIGN PERMIT Attach(2)sets of Engine�ered Pians. <br /> ""'PROPERTY SURV6Y re uired for all NEW constcucdon. <br /> Directlons: <br /> Ffll out appBcation completely. <br /> Ovmer&Contractor sign back of appllcatior�,notarized <br /> .. If over 52500,a Notice of Commenc�men�ls required. (AlC upgrades over 57500) <br /> Agent(for the contractor)or Power of f�ttom y(for the c�wner)would be someone with notarized letter from ovmer authorizing same <br /> OVER THE COUNTER PERMITTING (Fro�t of Applicatlon Only) <br /> Reroofs If shingles Sewers Serv�ce U grades A/C Fences(PIoUSurvey/Footage) <br /> i <br /> Driveways-Not over Counter if on pub;ic ro dways.,neods ROW <br /> • { �t <br />