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ts'is-rtsv-uv�u i C;liy OT L@pllyffl111S r@�t711i HpPIICailOfl rax-o�io-iou-vu�i <br /> Building Department <br /> /Y��a�►J�9 <br /> Date Recelved� � �� ,� pFaone Contact for P rmittin �d 3 Z6�. -- g� <br /> Owner's Name s�2,C.c»Zf� 1�,N2�. Owner Phone Number �%� ^� 23d-�g�� <br /> � � � <br /> I � � <br /> Owner's Address ��.�� '_�i��il r/ 33S�f , Owner Phone Number <br /> � � <br /> Fee Simple Titleholdar Name C � Owner Phone Number � <br /> Fee S(mple Tftleholder Address C� <br /> � , <br /> JOB ADDRESS �I� � �'!� S____ I! 22.Ph�.�Y H i 1/S �L 3 3 5 y a LOT# 7 7 <br /> 1— i <br />. SUBDIYISION �� � ��J ll , PARCEL ID# O�-�G" �-�'�>�� `�%���U ` d�'� <br /> II I �� (OBTAINED FROM PROPERTY TAX NOTICE) <br />' WOF�K PROPOSED NEW CON' STR ADD/ALT � SIGN Q Q DEMOLISIi <br /> � INS�ALL �E� REPAIR I • <br />-= PROPOSED.USE Q SFR �] COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLO K � FRAME � STEEL Q <br /> DESCRIPTIONOFWORK I2e � �on►�ac�� (�n1�"tS S� Z�,/Sile r� /j$2�o <br /> � <br /> BUILDING SIZE � SQ FOOI'AGE� HEIGHT <br /> � <br /> BUILDINO $ �� 6 0 I � VALU�ITION OF T TAL CONSTRUCTION <br /> — � <br /> QELECTRICAL $ i AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � ! <br /> � � �����✓ <br /> QPLUMBING $ <br /> � � , � <br /> QMECHANICAL $ I VALUATION OF ECIiANICAL INSTALLATION � <br /> ;� � 1 <br /> � <br /> � �'� � . <br /> QGAS Q ROOiFING �] SPECIALTY OTHER � '",��� <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZON�AREA QYES NO� <br />' C;_�� �, z� � �-�� �.�� <br /> �� <br /> BUILDER ` �� O PA Y Loc�-eS ,ldoMe, Ce�T�2�' '� <br /> SIGNATURE � / I/ /` REGISTER D Y/ N FEE CURRE� f Y/ <br /> � <br /> G i��� � <br />, Address O �O K O � I � . �``��A��`y 3 i"��� License# �C...�o[, ( 5�� �z7�-� .� <br /> i <br />� ELECTRICIAN � �OMPA Y <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> t— <br /> Address _J � License# <br /> � � <br /> PLUMBER � COMPA Y <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I �, - <br /> License# � <br /> MECHANICAL COMPA�Y <br /> SIGNATURE FtEG15TER�D Y/ N FEE CURRE� Y/N <br /> Address I License# <br /> — � <br /> OTHER COMPAPIY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 1 N <br /> I I � <br /> Address Lfcense# <br /> i�11�itH�fifi�t�thhht <br /> RESIDENTIAL Attach(2)Plot Plans;(2 sets of Bullding Plans;(1)set of Energy Forms;R-O�W Perm(t for,new construcUon, <br /> Minimum ten_(10)workir g days after submittal date.,Requlred onsite,Constructlon Plans,.Stormwater Plans w/Siit Fence Installed, <br /> - "- - � �- "Sitn WorKPeRSiiffor'sutidfvislonsTla`r e—rojects -- -- -�—�- � --- `� "-- -- " - <br /> - �"`^" ` Sanitary-FadllUes 81"-d�imps�er; g p " " - <br /> COMMERCIAL Attach(3)complete set�of B ilding Plan�plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pemift for new wnstruction. <br /> Minimum ten(10)workirig days after submittal date. Required onsite,Constructfon Ptans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciNtles 8 1 d,�mpster.Site Work Permit for all new proJects.All commercial requfrements must meet compllance <br /> SIGN PERMIT Attach(2)sets of Engin ered Plans. <br /> ••"'PROPERTY SURV�Y reduired for all NEW constructlon. <br /> 4 <br /> ,� . . <br /> Directlons: <br /> FIII out application completely. <br /> Owner&Contractor sign back of application,notarfzed <br /> if over SZ500,a Notice of Commenc iment fs requlred. (AIC upgrades over 57500) <br /> '• Agent(for the contractor)or Power of�lttomi y(for the owner)would be so �eone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of.AppUcation Only) <br /> Reroofs i(shingles Sewers Servi ce U grades A/C Fences(PlotlSurveylFootage) <br /> Drlveways-Not over Counter if on pub�ic ro dways..neods ROW <br /> � <br /> i <br />