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��i�-�nv-�vzu � �iry or cepnyrnins rermii Hppucation rax-o�i�-iau-uuc i <br /> ; Bullding De lartment <br /> � Mp JOCR <br /> ,f � I <br /> Date.Recelved — i , Phone Contact for Permittin 8 / 26 <br /> Owner's Name ���'} I �2�_ i Owner Phone Number S��o -2Y 2-7 e 2. <br /> Owner's Address s/�a►�� � Owner Phone Number <br /> � <br /> Fee Simple Titleholder Name � � Owner Phone Number <br /> I <br /> Fee Simple Titleholder Address C_ , <br /> JOB ADDRESS ���� I '!l+ � 2�2.1'k2Y�''��I s FL 3 3 S"��- LOT# F � <br />� � <br /> SUBDIVISION C�`� �"� �Z�I FL f►i/ PARCEL IDt! li I��2�-2/-bE?iG� �CJ.3�'1'oCh ° b(S� <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW iCON57R ADD/ALT Q SIGN Q Q DEMOLISH <br /> B INST�ALL � REPAIR � <br />� PROPOSED.USE Q SFR �] COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLO�K � FRAME � STEEL Q <br /> DESCRIPTION OF WORK 1`e!I f��� � D O U/L t��+i�TS S�2� S['Z� f C.. ����f�( �- �� <br /> �— <br />�� BUILDING SIZE I SQ FOOI'AGE� HEIGHT - <br /> OBUILDING $ VALUATION OF TI TAL CONSTRUCTION <br /> 1��-r_� <br /> QELECTRICAL r$ I AMP i ER�VICE � Q PROGRESS ENERGY Q W.R.E.C. <br /> L_ . <br /> OPLUMBING $ i , �v <br /> C�-� �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> C <br /> QGAS Q ROOiFING �] SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS �i � FLOOD ZONE AREA QYES NO <br /> , � G �,e.�^ 1�? <br /> ~ I / <br /> BUILDER � �I// .� �j� �COMPAIVY 4 0+..�-6 S� l-�oM�, C e�T�2� � <br /> SIGNATURE � � <br /> 0 'i l ` �"'Q'e" "� REGISTERED Y/ N FEE CURRE� � / <br /> i <br /> Address O QOK O ��✓ `��A���' , ��"��� Llcense# �.,�o�, ( .5� ��� � <br /> I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> — <br /> Address �— � License# � <br /> I I <br /> SIG ATURE _ ] REOG STP RED Y/ N FEE CURRE� Y/N <br /> � i <br /> I <br /> Address i � � L(cense# � <br /> � <br /> MECHANICAL ' � COMPAIVY <br /> SIGNATURE I FtEGISTERED Y/ N FEE CURRE� Y/N <br /> � <br /> Address � License# � <br /> � <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �� � Lfcense# <br /> iiii�htfi�Ft <br /> RESIDENTIAL Attach(2)Plot Plans;(2�sets of Bulidfng Plans;(1)set of Energy Forms;R-O-W Permit for new construcUon, <br /> Minimum ten(10)workir'g da s after submittal date. Requlred onsite,ConstrucUon Plans,Stormwater Pians w/Silt Fence installed, <br />,_ Sanitary Fadlitles&td�mps er Site.V!rork Permit for subdtvlslons/large proJects ___ _ - _ __�__ �___ <br /> COMMERCIAI.' Altach(3)complete set of B ilding Plan�plus a Uf�Safety Page;(1)set of Energy Forms.R-O-W Permit for new consWctlon. <br /> Minimum ten(10)worki ig days after submittal date. Required onsfte,ConstrucUon Plans,Stormwater Plans w/S(It Fence installed, <br /> Sanitary Facilitles 8�1 di�umps er.S(te Work Permlt for all new proJects,All commerclal requirements must meet wmpliance <br /> SIGN PERMIT Attach(2)sets of Engine��ered Plans. <br /> ""PROPERTY SURVP�Y re uired for all NEW consFruction. <br /> D(rections: I <br /> Fill out application completely. I' <br /> Ovmer&Contractor sign back of appli(;ation,notarized <br /> If over SZ500,a Notice of CommencE�ment is requlred. (AIC upgrades over 57500) , <br /> "• Agent(for the contractor)or Power of f�ttomiey(for the ciwner)would be someone with notarized.letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING I(Fro�t of.Applicadon Only.) <br /> Reroofs If shingles Sewers Servf ce U grades AJC Fences(PIo�Suroey/Footage) <br /> � <br /> Drlveways-Not over Counter If on pub�ic ro dways..neods ROW <br /> � <br /> i <br />