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o,�-r��v c:�ty ot�ephyrhiiis Permit Appfication Fax$13-?80-4421 � <br /> , BuNding Department <br /> te Recetved Phone Canfact for Permitting ��� ��'� - � �j <br /> rner's Name �t��� %� �G�L!`7/� i/�` Owner Phons Number O ,3 r�fc� <br /> rn�ar's Address ���r � ����� Owner Phone Numbar � � <br /> e Simple 7itleholder Name � � Owner Phon�Number �� � <br /> �Stmple Titte6older Address <br /> e�aoaR�ss f��/�' g '�` �'�'� �,?�rus- /c�.. �.�.� �o=# �� <br /> gaiv�sioN � �� p�c���Q# /l � �� L>G�ll� /Dc.�'D� L)� �c� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> )RK PROPOSED e NEW CONSTR� ADD/ALT � SIGN [� Q DEMOLISH <br /> INSTAi.I REPAIR <br /> .OPOSED USE Q SFR Q COMM Q OTHER <br /> PE OF CON3TRUC7#ON Q BLOCK [_] FRAME � STEEt � <br /> SGRIPTIl,}N OF WORK <br /> �ILDIMG 81ZE ���� 5Q FOdTAGE� HEIGHT [�� <br /> QBUILDING �6 � VALUATIO�!OF TOTAL CONSTRUCTIQN <br /> QELECTRICA[. �� AMP SERVICE Q PROGRESS ENERGY C] W.R.E.C. <br /> QPt�UMBING (y>_-� <br /> � <br /> C]MECHANICAE. $ 3 g��/ Oa VA�.UATiON OF MECHANtCAL INSTAILATIOtV <br /> QGAS Q ROOPING Q SPEGIAITY � OTHER <br /> IiSHED FLOOR EtEVATIOi�S ��� FLOOD ZONE AREA QYES NO <br /> 1LDER CdMPANY <br /> iNATURE REGISTEREp Y! N FEE CURRET Y/N <br /> Address Lloense# �� � � <br /> cCTRiCIAN COMPANY <br /> iNATURE REGISTERED Y/ N FEE CURRER Y/N <br /> Address License# �— � <br /> )MBER � COMPANY <br /> �NATURE RECiISTERED Y J N FEE CURRER Y I N � <br /> Address License# �—� � <br /> GMANICAL � ���/ � COMPANY �/��R (S �D !3/llte-C��'Y� �N� <br /> NATURE ��'"���+� ' ""�'rn""�'' REGISTERED Y/ N FEE GURREh Y/N <br /> Address ���1 � ��` /�C 2 �L /C ��S�f/ License# {.,�/��'0 °!����cf'1 <br /> �ER J COMPANY <br /> NATURE REGISTEREb Y/ (V FEE CURREA Y I N <br /> Addrass - License# �— � - � <br /> ilDENTIAL Aktaoh{2�Plat Plans;(2)sets of Bulfaing Plans;(1)set of Energy Farms;R-O-W Permit far new conshvction, <br /> Minimum ten(10)working days after submittal date. Requtred onsite,Construction Plans,Stormwater Plans w!Sllt Fencs fnstalled, <br /> Sanitary Faciltties&i dumpster Site Work Permit fcr subdiv�sions/large projects <br /> AMERCIAL Attach{3)complste sets of Sufldfng Pians ptus a�ffe Safety Page;(4}set of Energy Forms.R-O-W Permit for new consWction. <br /> Minimum ten(10)working days'afte�submittal date, Requ3red onsite,Construction Pians,Stormwater Plans wi Sllt Fence 3nstalted, <br /> Santtary Facltities&1 dumpster,Sike Work Permit for all new proJects.All commercial,requlrements must meet compliance <br /> N PERMIT Aftach(2}sets of Engineered Pians. � <br /> """PROPERTY SURVEY requlred for all NEW construcdon. <br /> ctions: ,_ <br /> Fill out application completely. � f � <br /> Owner&Contractor sign back of appticatlon,notarized � <br /> If over�2500,a NoNc:e of Cammencement is raquired. �A/C upgrades over�75d0} � � �, C°�� <br /> '� `v". i� ^'--.._ ...`.1 v <br /> Agent(far the�ntractor)or Pawer of Attomey{for the owmer}wautd be someone with notarized tetter from owner authorizing same ' <br /> :R THE COUNTER PERMITTlI�tG {Front of Applica6on Onty} � . � ,--- - ,_ ._.,-�._ ._.,. ._..;..,� _.....; <br /> �ofs if shingles Sewers 8ervice Upgrades R!C Fencss{PIoUSunreyfFootage} ` �'a,�4��,:�;` ,.,, f = <br /> y� . :;;, ,,',; : t." ': <br /> . .. . �.Y� : F <br /> Drivew�ys-Not aver Gaunter if on public roadways..needs RQW _.= , _ , „,,,,,; ., � - <br />