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_._ .__ ___„ � � �ny ar�epnym�iis rerm�t Appiication Fax-s�aaso-oa2� <br /> Bufiding bepartmeni <br /> i .. 4 ' <br /> I <br /> iDate Reselved phone Contact for Permltttn <br /> � r <br /> Chnme�'s Mame fJ��o�-��, ' l-�f � Owner Phane Mumber 7�=5��� <br /> Dwner's Address �.�'.3Z>� � .ai �v�-e�9 l�ry ,.�i�c�r'�' �j.� Owner Phone Number � ��� <br /> Fee Simpte'iitteholder Neme �� t Owner Pfione Numbar ry � <br /> �ee Simple Ti#lehoider Address �� <br /> aQe A�DResS � � �,3 !S' � 3��'�;� �.�?�lz4�-,3� Ept# ��_� <br />, ,`"" ; <br /> � �� i <br /> 5U8DNISION ���ivw��r11,.�-v -�- � PARCEL It?# �:��,%� �`G�"�a q—�d � <br /> I (OBTAINED FROM PROPERTY tAX NOTICE) <br /> WORK PROPOSED ; NEW CON5TR 8 ADD/AL7 � SIGN � Q DEMOLISH <br /> I INSTALL REPAIR <br /> PRi�ROSED llSE �I ' SFR Q COMM � OTNER <br /> TYPE t�F CONSTitUCT10N � BL.00K Q FRAME C� STEEL Q <br /> QESCRIPtI(!M OF WORIC � �-% t�� <br /> BUILDING SIZE �� � SQ FOOTAGE�_�� F!ElGH`I' ��r_�� <br /> [�BU1LDiNG $� �.� �� VALUATION OF TOTAL COMSTRUCTION <br /> QEIECTRtCA� $I' � � AMP SERVICE Q PROGRESS ENERGY CJ W.R.E.C. <br /> i QPLUMBINf3 $I <br /> � <br /> QMECHANtCAl. $!. ; � VAI.UATtt1N OF MECHANICAI INSTALLATION <br /> I <br /> � [�]GAS Ci� J E200FING �J SPECIALTY �„� OTHER <br /> =1NISHED FIOQR ELEVA7lOt�[S I �� FLOOD 20M1tE AFtEA [�YES NO <br /> I <br /> � <br /> 3tltLDER -�-� �� <br /> 'stCsNATUttE , c �y�.�l c,�� �'C'— R OM5'fERr D Y/ N FEE WRR � Y!N <br /> 'I Address <br /> I Ucense# ��`��� <br /> , - i � ,1 ,o <br /> `eLECTRlCIAN .�,�„�,r.�..�:'"'� COMPANY r)i��C� �/'�t 1�+�-�i ft �``t�6��-. <br /> �IGNATUFCE � „ REGIS'tERED Y I N FEE CURREt� Y I IV <br /> Address ( License# �d�2- �� <br /> ��uMe�a `�,�""' �`J{ �f(��.�..� Ct�MPAP1"Y �t,�l�;3 L, , W; 1 l�tt w' <br /> IIGNA"RlFtE l�`-� ��¢."" � Y <br /> REGtSTERED Y/ N FEE CURREh Y I I�I <br /> Address �� ucense# C,�c 1 y z .�"6���- � <br /> AECHANICAI. '� I /��"�"'�-- COMPANY lJ�l��r S �Qep /�ir/rt �AS e-� L,,, <br /> i1GNA7URE .""""' I REGlSTEREQ Y i N_ PEE CUR n Y J N <br /> Address �. License# G�GD �..�J� %�� � <br /> )THER Ct?MPANIf <br /> i1CNATURE I REGIS'T'ERED Y <br /> / N FEE CURREA Y!N <br /> Address ( l.icense# 1 . ��� <br /> tESIDENTIAL Attach(2�.PIot Plans;(2)sets of Bullding F?lans;(!)set of Energy Forrrss;R-O-W Permft for new cons#ructEan, <br /> Mlntmum ten(10);working days aiter submlttal date. Requlred onsite,Construcdon Plans,Stormwater Plans w/S!ft Fence installed, <br /> Sanitary Fadlitiss&1 dumpster,Site Wark Permit for�subdlvlstonsAarge projects <br /> :OMMERCIAI. Attach(3)camplete seCs of BuCiding Plans plus a l.Ife Safety Page;{1}set of Energy Forms.R-O-W f'ermtt tor new conshuation. <br /> Minlmum ten(10)worktng days after submittal date. Requlred onslte,Conshuc0an Plans.Stormwater Plans w/Stlt Fence Installed, <br /> Santfary Fadlities&i dumpster.Site Wark Permit for alt new projects.Ati commerciai requtrements must meet compllance <br /> cIGN PERMIT Attact�(2)sats of�Engineered�Plans. <br /> •'••PROPERTY SURVEY requlred for all NEW construcUan. <br /> ►irectlons; <br /> Fill out applicatlon completely. � <br /> Owner&Contractor sign back of appNcatton,notarized <br /> If over S2SOC,a Mottce of Commenaement is requlred. {,AlG upgrades over�7500} <br /> ' Agent{for the+co�tractor�ar Pav�er of Attarriey{for the awner)woutd be someone with natarized letter from o��mer authorizing same <br /> �, . <br /> lVER 7HE GOUN`CER PERMI7TlNG {Front of Appiica8an Only) <br /> ;eroofs if shingles Sewers �j,Servfce Upgrades A/C Fences{PIot/Survey/Footage� <br /> Driveways-Not aver Counter#I�n pubiic roadways..needs ROW <br /> i <br /> ' , <br /> �' <br /> f <br /> �, - <br />