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ts'i.3-rau-uv�u v��,y v� �.rt,��y�..�,o., . ..,.,..�, .�..r,...,.,....,.. <br /> Building Qepartment <br /> Date Receivec! ^ Phone Contact for Permitting -- <br /> , <br /> Owner's Narne �"�4l°h'\l'2-z'i�'� V �n`�`�+'1 Ovrner Phone Rtumber <br /> Owner's Address� ����� ��°�bU�bbC�.- �,.(�D P ttwnec Phone Number� � <br /> .. ,_.. , , <br /> Fee Simple iitEeha[der Name Ownee i'hane 1Yum3�er� . � <br /> Fee Simple Titlehalder Address � . <br /> JOBADDF2ESS; ���� !'�uC..G�.Ol.c.1U0GL �J�� ��'l�tl'"►ll�S� t'� 33J'�'y'�- LOT�# �✓ <br /> sue���v�sior� ' ��'��'�c� �S-fz�-r_..s � ;PARCEL_!D# �3""Z� -z(- �1�(o- D b o�- 0 6'3 0 - <br /> � �(OBTAINED FROM PRC3PERTY TAX NOTiCE) <br /> WORK PROPOSED. e NEW CONSTR e ADD/ALT C] SIGN C] MOVE C] DEMOLISH <br /> ` � � li�ISTA�L REPAIR t v' ���'� <br /> PRQPOS��11SE , Q SFR Q COMM CJ OTHER � ' <br /> TYPE OF CiDNSTRUCTiCiN 0 BLOCK � FRAME Q STEEL Q OTHER � <br /> DESCi2iE?Tt�N,OF:WORlCi #�� (1"C-� �f� �e"" (Otr� �� bC�.�1tYY��,o �1'(� � .. . , <br /> Bt!l�DIPlG 51ZE '. �_^� :SQ�t=00TA;GE�� � HEIGHT � " '� f . - ( � , <br /> 0 SUILDING �$ �, �.-- VALUATION O�•10TAL,CONSTRUCTION • � <br /> � -"���- - � _. �. ._. ._ . _. . . , :: . .. <br /> 0 ELECTRICAL � � AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> [� I'LUMBING ($ � ���b!'� <br /> � � <br /> Q MECHANICAL $ VALUA7IQN OF MECHANICAI.INSTALLATION � ' <br /> 0 GAS [� ROOFING 0 SPECIALTY Q 07HER , <br /> FINtSHED FLOOR ELEVAT{t}NS � � FIOCfD ZOR4E AREA QYES QNC3 <br /> � BlllLDER COMP�4NY <br /> i SIGNAi'1�12E REGISTERED Y J (�1 FfE Cl1RRENT � Y/N <br /> Ad�ress � �icense#, � ' ' � <br /> ELECTRlCIAN COMPANY - <br /> SIGIdATUE2E REG3STEf2ED Y I N �FEE CURRENT , 'Y I N <br /> .. <br /> � �0.ddress License# �. . � <br /> • , , <br /> . , <br /> PLIDMBEI2 COMPANY � <br /> SIGiNATUS2E • REGISTERED Y J N FEE CURRENT - Y 1{V <br /> Adciress License# �_ - - � <br /> MI�CHAIdIC�4i. COMPANV • • <br /> SIGNATUFtE RE��srEREO Y 1 iU FEE CURFtENT Y I 1�1 , <br /> i Address � - License# �- ' � <br /> I . _. `�. mr�-s� ���� ` .,��-- . <br /> 07HER.�, ,COMPANY � <br /> HIGNATUE2E� ���tsr���o Y N FEE GURREN T Y N <br /> Address ����� S�- 5�f'� h rhi<<s� �, �35�( :`�tcense:# ��G- �/<.3 Z:��C�� � <br /> RESIDEA171AL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set af Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten{10}woricing days after submitta(date. Required onsite,Constructton Pfans,Stormwaker Plans w/Sitt Fence insta(ted, <br /> Sanitary Facilities&`1 dumpster;Sike 1Nork Permit for subdivisians/farge projeets - <br /> CONiNiEFtCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Nfinimum ten{30)worEcing days after submittat date. Requtred onsite,Coast�ucl�an Plans,Stormwater Plans wl Silt Fence insta!(ed, <br /> Sanitary Facilities&1 dumpster.Site Wark Permit for alt new projects.Ali commerciai requirements must meef compiiance� � <br /> SIGW PE1iMIT Attach(2)sets of Engineered Plans. <br /> **"'PROPEF2`FY SURVEY required for alE 4VEW construction. . , ' <br /> I Directions: <br /> Fi21 out applicafian comp]eteiy. ' <br /> Owner&Contractor sign back of applicatian,notarized <br /> If over$2500,a Notice of Cammencement is required. (A/C upgrades over$5000) <br /> '* Agent(for the contractor}or Power af Attomey{ior the owner}woutd be sameone wi#h notarized letter fram owner authorizing same <br /> r <br /> 'OVER THE COUNTER PERMIITING (Front of Application Only) <br /> Reraofs Sewers ServEce Upgrades, . AIG Fences{PiatJSurveylFootage} <br /> Driveways-Plat over Counter if on public roadways..needs ROW : <br /> I <br />� --- -- -- - <br />