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<br /> ,� ,"�"`-° �`�::,;;,��-Ci of Ze h rhills Permit A lication � ----�--�-�M�����F�x-s�3-7so-oo2�
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<br /> , � ��� :-. ,`;'-. _� � � ,:? .. , � Building Department � .� ` - - . . .. - . . -
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<br /> date Recet�red« . �, . ,.'�;°',� . � _ -- Phone Go»tact for Permitftn '?�13� �� ` ,. `.�,��, �
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<br /> 4wner's Name L{ �� S � � Owner Phone Number t�� -� �
<br /> � 1'uden � t t C.�YJ�... �f�s1 �— �i
<br /> Owner's Address C.�d� 5 E'n u1a�c� /', Owner Phone Number �
<br /> Fee Simple Titleholder Name � I � Ownor Phone Number � �
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<br /> Fee Simple Titleholder Address i
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<br /> JOBADDRESS ,}�?.sl..� �'t�Gt%S � 2�� Ils �L . ,�5��( LOT#
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<br /> susn�v�stoH frt r�� �r�ri Z c r�s PARGEL 1D� �� `o� S=� �— [}C.�QI� — D���� --p 7 � 0 .
<br /> (OBTAINED FROM PROPERIY TAX NOTICE)
<br /> WORK PROPdSfiD e , NEW CONSTtt 8 ADDlALT �� �lGN Q Q DEN{OL{SH
<br /> INSTAL[. F2EPAIR
<br /> PROPOSEa USE Q SFR Q COMM C� OTHER
<br /> TYPE OF CONSTt2UCTtON Q IBLOCK Q FRANtE � S'i'EEL Q
<br /> DESCRtPTtON OF IN412K f�'� �.U� t,..,.�hG j�P 7 � 1 4 �? �YX�.C,O
<br /> 8U1LD1NG SlZE a Y K� CO � SQ FdQTAGE (.l�a � HElGHT ��
<br /> "nr-r'r�-^r�-a-r'�-r'r"�r^fTr^t-�-i-i-r-�T'�-rr rs-s-�-�-r-�rt-tTi-�-e-rr�"e'r�"!-r
<br /> QBUILDING ���,rTiaU-Q� VALUATIONOFTOTALCONSTRUCTlON
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<br /> 'QELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R,E.C.
<br /> QPLUMBING $ `'������
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INS7ALLATION
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<br /> ( Z-Se.�-�p tt.�,ry�-�-'�
<br /> QGAS Q iROOFING Q SPECtALTY � OTHER �
<br /> F1NtSHED FLOOR ELEVATtONS �I� F�QOD ZONE AREA QYES NO l •5 l �Q�
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<br /> -1�-f-E-a-1-1-1-�-1-1-F-f-1--1-1-1-1�-1-1-i�-E-f-I- f-f��l-�+'it`1-�f-l--1-1-E-i-�1-E-1-1-1-�f-f-1-f-1--1-1-1-1-1-M-�1-1-#-�-f-a-1-�-1-l-
<br /> BUILDER ��.�/ � ' � � COMPANY LI�L GG.�I'1'(/I'?UL�'1...
<br /> SIGNATURE �4'+�iL- REGIS7ERE� Y/ N FEE CURREN Y/N
<br /> Address C.pf'� �i !,c !�� ��7� / .'�,� 7�`^ License# rC../eG C�.������
<br /> ELECTRiCIAN I COMPANY
<br /> SICaNATURE REGISTERED Y/ N FEE CURREN Y/N
<br /> Address � License# � � .
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<br /> PLUMBER �f GONIPAAlY
<br /> SIGNATURE I REGISTERED Y/ N FEE CURREN Y 1 N
<br /> Address ( License# �� �
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<br /> MECt�1ANlCAL EdMPANY
<br /> SIGNATURE � REGfSTERED Y/ N FEE CURRBN Y/N
<br /> ABdress I License# � �
<br /> QTHER t GOMPANY
<br /> StGNATURE ( REGISTEREQ Y I IV FEE CURREN Y I N
<br /> Address I license# � �
<br /> IIIIIMIlI111NI11Ml1i111111 '1IIIIIIIIIIIIIfIt1111i1f1I11A � 11I1II111111'
<br /> RESIDENTIAL Attach(2)Plot Flans;{2y sets of Building Plans;(1)set of Energy Forms;R-O-W Permit far new constructlon,
<br /> Minimum#en_(10}workictg days affer submitta!date. Required onsiTe,Consfruc#ian Plans,Stormwater Plans w!Silt Fence insta3led,
<br /> Sanitary Facilitiss&1 dumpster;Site Work Permit for subdivisions/large projects
<br /> COMMERC.IAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)se#of Energy Forms.R-O-W Permit for new construction.
<br /> �VJinimum ten{'!0}working days after submlitaI date. Required ansite,Gonsfruction PIans,Sformwater P1ans wl Silt Fence irtsfatleB,
<br /> Sanitary Facilities&1 d mpster.Site Work Permit for all new projects.All commercial requirements must meet cornpliance - - -
<br /> SIGN PERMIT Attach(2)sets of Engin ered Plans.
<br /> ""'""PR4PERTY SURV�''Y required for atl NEV+1 consfructlon.
<br /> -i.f�l..f-.1-�hl-E.f.J-1-f-L.�..f-�E*�f-1-W-.4-1-M-�i�.�..l..l�.�l-E-I�M.f-��-�-1..1-j-1�#-1-4.i-.4-1-1-f-.1-I.A-i-1-E.k.f.�.l-i-�1-f�#.�1-1..4.1.�f-i-f-�
<br /> Dfrections: �
<br /> FitI aut appiicatian comple#eSy. +
<br /> Owner&Contractor sign back of apptication,nofarized
<br /> If over$2500,a Not7ce of Commencement ls required. (A/C upgrades over$7500)
<br /> ** Agent{for Ehe oonfractor)or Power of Attamey{for fhe owner}wouId Iae someone with notartzed IetFer from owner aufhorizing sarne
<br /> OVER THE COUNTER PERMITI'ING (Front af Applica6on Only)
<br /> Reroofs if shingles Sewers Service Upgrades AtC Fences{PiotlBurveylFaotage}
<br /> Driveways-Nat over Counter if on pub�ic roadways..needs ROW
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