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, - ' � Bufiding Department <br /> Ma-..rr t� <br /> Date Received <br /> Phone:Contact for Perm(ttin , �7 3 2�o -- C(,c{(o� <br /> Owner's Name CO l�l O RTDN Owne Phone Number $�13 - - <br /> Owner's Address '`j !� Owne Phone Number � <br /> Fee Simple Titleholder Name Owne I Phone Number � <br /> � <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS 3 SS 33 I ��7 ��- �2-P���/n���$ FL � �J' S/�. LOT# C� <br /> i <br /> SUBDIVISION {, h�f/S PARCEL ID# -'26-?_/� 00/D-O g 000 - O� 'nt D � <br /> (0 STAINED FROM PROPERTY TAX NOTICE) � - <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT 0 S1�3N Q Q DEMOLISh� <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM [� O'HER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 Sl'EEL Q � <br /> DESCRIPTION OF WORK // 7 f d t � �' ' vG '�NC�. (wl � �R�e .� <br /> BUILDING SIZE SQ FOOTAGE� H EIGHT ; <br /> �A <br /> DING $ q�/� QD VALUATION OF TOTAL CONS RUCTION <br /> l I <br /> DELECTRICAL $ AMP SERVICE I� PROGRESS ENERGY Q VV.R.E.C. <br /> OPLUMBING $ ��� <br /> C <br /> �MECHANICAL $ VALUATION OF MECHANICAL NSTALLATION <br /> OGAS ' Q ROOFING Q SPECIALTY � O HER ' <br /> FINISHED FLOOR ELEVATIONS FL000 ZONE AREA QYES NO <br /> �ii�ii-ftti <br /> BUILDER Q� COMPANY �I�FlG11e.5.: {�OM� C��S L(,� <br /> SIGNATURE �--(, REGISTERED -- Y%�N FEE CURRE� Y/'N <br /> Address License# G6� 1 SO$�-1 !`7� I <br /> I �ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED ; / N FEE CURRE� Y/N I <br /> Address � License# � <br /> PLUMBER ' COMPANY � <br /> SIGNATURE ' � REGISTERED �f/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGISTERED �r I` N FEE CURRE� Y/N <br /> Address ' License# � <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' - License# � <br /> ii#ti-FH <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plari§;'(1)set of Energy Forms;R O-W Permit for new construcUon, <br /> Minimum teri(10)worlcing days after submlttal date. Required onsite,Con trucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles 8 1 dumpster,Site Work Perm(t for subdivlstons/large pr�jects —__�, <br />�"`-COMMERCTIiC'—ECt ac-(3)complete�sets of-Buildfn`g Plans plus a Life'Safary Pag`e;(1)set`of Ene�gy Forms.-R=0=1N-P`ermit for new constnictfon. <br /> Minimum ten(10)working days after submfttal date. Required onsite,Consy�truction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facillties&1 dumpster:Site Work Permit for all new projacts,All clI�mmercial requirements must meet compl(ancEa <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. I <br /> ••""PROPERTY SURVEY required for all NEW.consWction. I <br /> �D <br /> Direct(ons: <br /> Fill out applicatfon completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is requlred. (AIC upgrades over 57500) . <br /> "" Agent(for the contractor)or Power of Attomey(for the ownerj would be someone with not�rized letter fram owner authorizing same <br /> OVER THE COUNTER PERMITtING (Front of Applfcation Only) <br /> Reroofs if shingles Sewers Service Upgrades AIC � Fences(PIot/Suroey/Foota e) <br /> Driveways-Not over Counter ff on public roadways..needs ROW <br />