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d�i.�-r�v-vvcv l..�IL�/ UI LC�f lyf f 11115 I"Cf(I IIL H��IIC:dLWf I � an'U IJ'/VV'VVG I <br /> i� <br /> ' `` � ^� Building Departm ent ��� i/M�� �Z( <br /> <�v <br /> Date Received � ) � Phone Contact for P ermitting ��/ J/�S���X��`3� <br /> � : � eat � i me � � t <br /> E�1.� cS /�,Q�y�s �'Git1.t�6�' /rfL <br /> Owner's Name -� - c�/ Owner Phone Number <br /> Owner's Address U ao�� � D<v'�'�d/� �� `�� 60O Owner Phone Number <br /> 1=ee�imple Titleholder Name � Owner Phone Number <br /> F2e Simple Titleholder Address �s�"�� <br /> Jt7B AQDRESS � y�02 CT/gLL L�,v �E//�''�iS/,Q�C4f /`L• ��sj� LOT# � I <br /> SUBDIVISIOf�f PARCEL ID# J�a-Sd�' dd�d, Q7a00-��/� <br /> (08TAINED F OM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR B ADD/ALT � SIGN � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR � COMM � OTHER <br /> T`CPE OF CO�STRUCTIOhJ � BLOCK � FRAME � STEEL � <br /> ucSCRIPTION OFVJORK ,�'�l"tt �/9�s'/�'�✓/�U '�/�.� P�/�'Tr/�'�Z�Sj,�t7G �`?�� <br /> 5UlLCING SIZE SQ FOOTAGE� HEIGHT . <br /> "'d'"i`6''Tf"d`uP'"�'�"3�i"`m""H�"'�/it�H'u�"'5�'�6�9�1�'I�fl"➢�'�1"1'�iTTI"ITriT1�TIT��TrTrTrT <br /> �BUILDING,�/p7v $��DO�-00 VALUATION OF TOTAL CONSTRUCTION <br /> � �ELECTRICAL $ ���Gc� AMP SERVICE � PROGRESS ENERGY � W.R.E C <br /> %� <br /> I`� OPLUMBING $ <br /> _-- r �✓� <br /> �MECHANICAL y VALUATION OF MECHANICAL INSTALLATION I � <br /> l � <br /> �GAS � ROOFING � SPECIALTY � OTHER <br /> FIiJISHGD FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> -. �F=-:a��n�:-�°c=°�--sd+:-�wF��-° m���.�6������P��:-����:--�-'r��7--��:--�- <br /> � f '.� d � , T o � ... <br /> BUfLDER '',{V"/, `��OMPANY �j_/61SlX ic��+-� <br /> SIGNA7URE �M������ REGISTERED Y N FEE CURRE� Y/N <br /> Address / X License# �s'/a��y�� <br />, r .C/J�-� O <br />' ELECTRICIAN COMPANY .S/�JS�X �+E`..5�� <br /> SIGf�ATURE ���� REGISTERED / N FEE CURRE� Y/N <br /> Address � �` '���sr `�'�77 License# �`f�a�d�y� <br /> PLU�BER COiVIPANY <br /> S1Gi�lATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> NIECNANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTNFR COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> S9la � 9 � CH ? & 10994H999 ➢ E � 69S9o1199i99E717i1l19l1111111111111111111111 <br /> RESIDFN7IAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permitforsubdivisions/largeprojects <br /> CO�MERCIAL Attach(2)complete sets of Building P lans plus a Life Safety Page;(1)set of Energy Fo rms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed, <br /> Sanitary Facilities&1 dum pster Site W ork Permit for all new projects.All commercial requirem ents must meet compliance <br /> SIGN PERh91T Attach(2)sets of Engineered P lans. <br /> """"PROPERTY SURVEY required for all NE W construction. <br /> :C�°��:...?�=3.-la°.�-.:-1�$m��H�[�F�6�l�.k�i..!..�{...C�1—f�-7�1..l..f—Im.l—�1..1-1—f-1-1—f..�lo{-1-1-0..���1� <br /> Directions: <br /> Fill out applic ation completely <br /> Owner&Contractor sign back of application,notarized <br /> Ifi over$2500,a IVotice of Commencement is required. (A/C upgrades over$7500) <br /> "' agent(for the contrac tor)or Power of Attorney(for the owner)would be s omeone with notarized letter from owner authorizing s ame <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter i f on public roadways..needs ROW <br />