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. ,�p hRyh;�rs . <br /> �uitding Department <br /> � rno f��CA <br /> Date Rece�ved ,; � 1 f� � Phone.Contact for Permittin �6 3 �� " 6� <br /> Owner's Name f� Owner Phone Number O-7" — � <br /> -_Dwner's Address �� 7 l�� sT Owne Phone Number � <br /> Fee Stmple Titleholder Name Owne Phone Number � <br /> Fee Simple Titleholder Address � <br /> � <br /> JOB ADDRESS S2I 7 �-/�h ST 2��RY�l �I S �L ��s�y� LOT# �lf� <br /> SUBDIVISION �2 G�i I PARCEL ID# I{-26 �1-�b1D -' I��f� ���3d � <br /> (O fTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NSTALLSTR 8 REPAIR u SIGN Q Q OEMOLISh� <br />� PRaPOSED USE Q SFR Q COMM � O"HER , � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � Sl'EEL Q � <br /> DESCRIPTION OF WORK �A � OOI� G N lT S �z� �L 2o y��' � � <br /> l <br /> BUILDING SIZE SQ FQOTAGE�� HEcIGHT ! <br /> � <br /> UILDING $ 3?69 VALUATION OF TOTAL CONS RUCTION <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q VV.R.E.C. <br /> � <br /> OPLUMBING $ � �� � <br /> � �� �� � <br /> OMECHANICAL $ VALUATION OF MECHANICAL NSTALLATI� o� b • <br /> l�b l r r <br /> OGAS '� Q ROOFING Q SPECIALTY '�] O HER � � I� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> ithl�itii <br /> BUILDER COMPANY ,L-f� G� , M CQ� P.2S LLL � <br /> SIGNATURE REGiSTERED � Y/ N FEE CURRE� Y/'N <br /> Address QO (��X 1�{Q 3 �A�tGO �L 3Z�8 License# C�G1 S��f���7 � I <br /> ELECTRICIAN COMPANY � II <br /> 5iGNATURE REGISTERED / N FEE CURRE� Y/N I <br /> Address License# � <br /> PLUMBER COMPANY � <br /> SIGNATURE � REGISTERED 'l/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGISTERED ��/ N FEE CURRE� Y/N <br /> I Address ' License# � <br /> I ' � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address L(cense# � � <br /> I iiiii-htti <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;�.(1)set of Energy Forms;R O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Con tructlon Plans,Stormwater Plans w/Silt Fence Installed, <br />= Saoitary Facillties&1 dumpster;Site Work Permit for subdivisions/large pr�jects <br /> COMMERCIAL Attach(3)compl_ete sets of Build(ng Plans pius a Cife SafEtyyPagQ;(-4)-set-of Energy Forrris._R=0=V4 Permlt-for-new_constn.iction.--� ___, <br /> Minimum ten(10)working days after submittal date. Required onsite,Cons�tructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 81 dumpster.Site Work Permit for all naw projects.All c�mmercial requirements must meet compllancE� <br /> SIGN PERMIT� Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY requ(red for all NEW.construction. <br /> � <br /> Directfons: <br /> Fill out applfcation completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is requlred. (A/C upgrades over E7500) . <br /> "• Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth not jrized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicatfon Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C �Fences(PIot/Survey/Foota e) " <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />� <br />