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t3'i.3'1t517-t7UGU UIC�t tJi LT.,�.l1 ty�l It��o � ce����a r1�N��vua�v.�
<br /> , Building Department � -
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<br /> Date Received � � � , ' ' Phone Cantact for Permitting �c 3 78� -- 19.o, �._ . x I
<br /> Owne�'s.Name �.�U(� l � ��1 � Owner Phone Number ��,/' lO V i:� ����V -• '
<br /> .,.yr� �...l:..y�, . , , - . -
<br /> O.wnec's:Ad�ii�ess'�, � l ��� ��r�,� C�t,tfY�lYl�Ck #-/�� t\ 'r ti��virnerPhoneNuritber� � �
<br /> :. 4..r,...�.._ .� �-•
<br /> Fee Simp]e Titteholder Name Owner Fhone Number� �
<br /> •Fee Simpte?itleholderAddress � " ' �
<br /> dOB ADdRESS�. ��SQa 1.����-'� �4rY}/Y1 GC�C. D�� � r �S �I s.����� LOT# � � 1
<br /> SUBDIVISION, ' ��C,. R(�'n � PARC,EL';ID#. ����S a I 'D��.(�'.QU�Q' �� �V' �
<br /> , iw., ; __,_
<br /> ' ' � �(OBTAiNED PRQM PROPERTY TAX NO'i'ICE)
<br /> WORK:PROPOSED e NEW CONSTR ADD/ALT �� SIGN [� _ MOVE � DEMOLISH
<br /> •u-.,._,.,_._�.,�,�..:,,__,�;, . (NSTAL�. e REPAIR
<br /> PR4POSED USE , [� SFR � COMM Q OTHEFt '
<br /> TYPE QF CONSTRUCTION � BLOCK � FRAME Q STEE�. � OTHER�— —�
<br /> DESGRiPTION;QF:WORKf T�� (}� (�{.-° -�Uf�t' (�S cS l9�f"f"C�S I���Yii. �S C�J��'�'t S tr}�Yt�u-.('{C,(,�' ! , G
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<br /> ' , :. � SGt:FOOTAGE HElGttT •�
<br /> _ , . , ::.� .,,,._,..
<br /> BUI�DIN�SfZE ,,. ,•
<br /> j�����. - : _..
<br /> Q BUILDING $ � ..U�..�;; =VR�l1AT(OtJ OF=TOTAL GC7NSiFtl1GT10N ` - � „
<br /> _ �'jp��,(;�r�v�� `•,..,.. � _ , . ,. . - ,.; �. � _ .
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<br /> Q EI.ECTRICAL $�'-- � AMP SERVICE Q PFtOGRESS ENERGY C] W.R.E.C:
<br /> � �
<br /> � PLUMBING $ �f� G� °"� •
<br /> C] MECHANICAL � � VALUATION OF MECHANICAL INSTALlA710N r/ ""'"7 � �
<br /> . �� �� 1.
<br /> Q GAS - [� ROOFING C] SPECIALTY Q OTHER , •
<br /> FINiSHED FLOOR ELEVATIONS � � FLOQp Zt?NE AREA QYES QNO
<br /> BUII.DER__._._ � ' GQMPANY. • --
<br /> - -. __ _ - -------- , . , . . - ,-
<br /> S1G1t�ATURE REGISTERED Y/ N FEE GURREN7 Y I i�
<br /> Address Llcense# �_ . �
<br /> ELECTRlClAN - COMPANY
<br /> S1GNA'TURE REGISTERED Y I N FEE CUftRENT `Y J�I
<br /> Address L'scense# �' ' �
<br /> PLUMBER CQMPANY � '
<br /> StfNATURE � RE�tSTERED Y/ TV FEE CURRENT Y J N
<br /> Address License# ��� �
<br /> MECNANICAL COMPANY � � �
<br /> SiGNATIiRE REG3STEREp Y I N FEE CURRENT Y I N ,
<br /> Address � � L'scense# �^ � �
<br /> 07'WER;;-,_. _COMPANY RQQ�(r �C , ' . : ' �
<br /> StGiStATt1RE=< ft��isTE��� � Y N FEE CU ENT Y N . ,
<br /> Address !� S 4C c5 �r�� I ��S�{� �.Liaense# [+��l��il 5S 0� �
<br /> RESIpENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;Fi-O-W Permit for new canstruction, �
<br /> � , Minimuriy fen{10}working days after sabmiftat da#e. Requlred onslte,Canstruct�bn Plans,Stormwater Plans vr!Sllt Fence 3ristalled; �
<br /> Sanitary Facilities;&1 dumpster;Sit'e Work Permit for subdivisionsllarge projects ` , � ".
<br /> COMMERCIAL Attach(3)sets ofBuilding Plans;(1)set of Ene�gy Forms.R-O-W.Permit for new canstruction. , '
<br /> Il+iinimum ten{10}wotking cJays affer subm3ttat da#e. Required ansite,Gonstructian P[ans,Sformwater Ptans wl Silt Fence instalted,
<br /> Sanitary Facilities&1"dumpster.Si#e Work Permit for all new projects.Ali commercial requirements must'meet campliance`� � � ,
<br /> SlGN PERMlT Attach{2)seks of Englneered Plans. , , '
<br /> **'"`PROPERTY SURVEY required for al1 NEW construction. ' _ .
<br /> Directlons; � ' .
<br /> FiII out appticaffon comptetely. ' �
<br /> Owner&Contractor sign back of appliaation,notarized
<br /> ' If aver$2500,a Notiae of Gamme�cement is required. (A!C upgrades over$5000j
<br /> '`'` Agent(for the contraotor}or Power of Attomey(for the owner)would be someone with notarized lefter from owner authorizing same
<br /> 'OVER TH�C.OUNTER PERMlTTING {Front of AppAcation Only) ,
<br /> Reroafs Sewers Sen+iae Upgrades AtC Fences(PCottSurveylFootage} �
<br /> Drs'veways-Noi over Counter If on public roadways..needs ROW
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