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Bufiding Departmeit � <br /> � i <br /> I e,a�I i ts4 <br /> Date Received —�� 's � <br /> � Phone.Contact for Permittin �S l 3 Z�� – a�j G� <br /> Owner's Name V►(3�jQ'f'�� ,�9p(�Tp� Owner Phone Numbelr �« -7�� ' �J�7� <br /> I <br /> Owner'sAddress � ��/G � �v+� 2e?hs2y1+;/!5 I�L3 �2�ynerPhoneNumbe�r <br /> Fee Sim�le 7ltleholder Name I <br /> I � , Owner Phone Numb�r <br /> C � <br /> Fee Sim��le 7ltlehoider Address � <br /> JOB ADDRESS '��4� . � �Ll�2_ ZP��IR�`/�1 i IjS F I 33sy� � LOT# I °�Z <br /> , i <br /> SUBDIVISIOPI n?�o�es /s7 �dd PARCEL ID# !tt 26-�/- oa rG� � C7 27�p ^�d/O <br /> � I (OBTAINE�FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED e NEW CONSTR 8 ADD/ALT Q � SIGN [� I Q DEMOLISH <br /> INSI'ALL REPAIR � <br /> PROP03�ED.U3E Q SFR, Q COMM � OTHER ; <br /> TYPE OF'CON3TRUCTION Q BLOCK Q FRAME � STEEL Q i <br />��i DESCRIF�TION OF WORK R�PI/a C,� 2 �p ;a (,,�No`f'S , i 7� Si.Z.e /�L. y 9a�o � <br /> � <br />�i BUILDINiG SIZE I SQ FOOTAGE� HEIGHT � <br /> ��u <br /> C]BUILDING $ �� j�`�� VALUATION OF TOTAL C� NSTRUCTION � <br /> C]ELkCTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> �� I � <br />' C]PLUMBING �� i I \�\�� <br /> C�MECHANICAL $ VALUATION OF MECHAN CAL,INSTALLATION� � <br /> �� � <br />� C�GAS [� ROOFING I I <br /> Q SPECIALTY C] OTHER j <br /> FINISHE[)FLOOR ELEVATIONS FLOOD ZONE AREA QYES � NO <br /> C� ��� ; G ��� �� <br />�I � �ff. <br /> I ,. <br /> I BUILDER. �j���� w � � D�OMPANY � 4_ ' � <br /> � �w-eS l-lo.��,�Ce� �23' � <br /> SIGNATUIRE �U '�n-�" REGISTERED Y/ N FE�CURRE� �Y I <br /> AddUess �'"O QO!� � �f 1���✓" 2���'�'' 3�'��� Llcense�# ��O� S� � / <br /> � <br /> ELECTRICIAIV COMPANY , I <br /> SIGNATIYRE REGISTERED I Y/ N FE CURRE� Y/N <br /> Address �— � Llcense# <br /> I <br /> PLUMBEI� COMPANY I i <br /> 51GPlATURE REGISTERED i Y/ N FE CURRE� Y/N <br /> Address � License# <br /> MECHANICAI. COMPANY I I <br /> 51GNATURE REGISTERED Y/ N FE CURRE� Y/N <br /> Address License# I <br /> DTH�R COMPANY I , <br /> SIGNA7URE REGISTEREp I Y/ N FEE'CURREA Y/N <br /> Address � Llcense# � <br /> -ti-ffttfi-t ifi�ttiti-Ftit � � <br /> RESIDENTIAI_ Attach(2)Plot Plans;(2)sets of Buiid(ng Plans;(1)set of Energy Forrr�s;R-O-W Permit for new construcUon, <br /> Mlnimum ten(10)wo�king days after submittal date. Required onsite,�onstructlon Plans,S ormwater Plans w/Silt Fence Installed, <br /> Sanitary-Facilides&1 dumpst�er;Site Work Permit for subdivlsions�ar�e proJects <br />- - ,OM!N[ER�IAL Attach_(3)_complete-sets=of-6uflr±fng-Rlans-�lus�_Life Safety P_age;_(1)'set of Energy_Forms._-O-W Permit for new constructlon. _` <br /> Minlmum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, � <br /> Sanitary Facilitles 8�1 dumpst�sr.Site Work Permit for all new proJects.�All commercial requir�ments must meet compilance <br /> 51GN PEFtMIT Attach(2)sets of Engineered Plans. � ; <br /> "'""PROPERTY SURVEY required for all NEW construc8on. ; � <br /> )irec�tlon�s: i i <br /> FIII out applicatfon completely. ' <br /> OwnE�r&Contractor sign back of appl(catlon;,notarized' ! 'I <br /> If ov�sr 52500,a Notice of Commencement�is requlred.. (A/C upgrades over 3TSb0) i <br /> '' Agent(for the contractor)or Power of Attome�y�(for the owner wouid be someone wltti notarized letter from owner authorizing same <br /> ;_���. <br /> _-_ _..�, i <br /> )VER THIE COUNTER PERMIITING (FronR of�Appllcation�Only) ! <br /> �eroofs If shingles Sewers Service Up'grades A/C Fences(Plot/Survey/Fqotage) I <br /> _ -.• :..: . . ...:..:...__ ,_ _. .....�. � i <br /> Driveways-Not over Counter if on`public roeiiways:.needs:ROW i I <br /> � . � • I <br /> � , '<+; ; i <br /> ,. , ,..;. , ; <br /> ' . - ;, <br /> .. .�, � _... _.. „s.�r.... .:.. , _:_._.,._ � � <br />