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' — � I <br /> V <br /> t , <br /> a��-7sswo2a. Gi�-o�.Zeqtr�hifl�.!'emzit R�p4ication F�-a��-�ao-ooz�_ <br /> . Z��l�'�'`� 2v%d;ng-�eN'1fNrreY- <br /> Oafe Received � ph"dna Contact foc Fermtltih� f � X. — d Q� , <br /> 'Tr�TYT7'- 7-7-I'Y t' <br /> � Owners Name �Owner Phone fVumber <br /> Owner's Address + �Q.� Owner Phone Number �� <br /> Fee Simple TtUeholder Name Owner Phone Plumber <br /> �=ea.:rrr���rr�i��:�t���=a��t�!�:- � Y <br /> JOBADDRESS � �I'1 �jV Y i1 � '(�. •b _._. LOT# � <br /> SUBD71/IS10N �e v� r�l c�. p,����� c7Z-�� 'C..� � '�dJ�d -. � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NIORK.PROPIISED NeW.COwSTR� .MDD/ALT Q SIGN � Q DEMOUSH <br /> ' INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> 7YPE OF COIdSTftl3Ci14t� SLOCK. Q FfiA?J=c �. ST�Ei �. <br /> OESCRIPTfONOFWORff 1 � <br /> BUILDING SIZE ' SGY FOOTAGE� RECGIiT � <br /> �BUILDING ��� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL S AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> '���P.L43M81S4G S � !7�J7 <br /> `>t �1 � � / !/ <br /> �Q MECHANICAL 'S VALUA710N OF MECHANICAL IN5TALLATfON v l � � <br /> e � ��� <br /> �GAS � ROOFING .� SPECIALTY.� OTHER � " 5�� f � �q <br /> � � � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER 'C�p (� `�Tj(� (� ^ �'1�„O� COMPANY <br /> � SiGMAI'l![dE ' ��L•i \S�CJ � ���r�aEo (: v e �s [ �z�—,� Y t-�r . <br /> aad�� � l-l.a'�-'�ct[ 1 ��(°�C�i �I'"J �. <br /> ELECTRICtAN Cpry�pp{�y <br /> SIGNATIlRE REGISFERED Y� h! FEEctiRREn N/Pt . <br /> Address Lf cense# <br /> PLUMBER COMPANY <br /> SIGNA7URE REGISTERED Y/N FEE CURRE� Y/N <br /> i=,:.iuxss� �! -�! � <br /> �w�:; � <br /> MECHANICAL '� COMPANY <br /> SIGNATURE � u�G�S�a Y! N �ecut�n Y!N ' <br /> Address ���� <br /> flTHEft COMPAiJY <br /> SIGNA�URE REGI&rea�o Y/ N F�cuwzEn Y/N <br /> Address License# <br /> .. a.d',? �,.,3.�;Gy. ':,5�.g��g�.�,r v�a+sy��-'-3 , _ ;.�; v�:i�.,.c,:��,.a�� �e.y <br /> q,�:�.� , �- - _ .,- -�. .:.._- , _ _ � .. .. � ...-, -. ..,. � ;�. __ :,.s_:n-�'..E' �3_''. :3 a�,v_�S';� <br /> RESIDENTIAL Attach�2}PIat.Plans;.(2}seisofBuilding.F(ans;lEt.}set.ofEoergy,F,o�rns;R-O-Nl.Pecmitfocne�xconstruction,Y <br /> Minimum ten(t�j'wor(d'ng days after su6mittaGdate. Required onsRe,Cnnstrucfton Plans;Stnrtrtwatec Plarts wfSi([Fence Cnstatfed, <br /> Sanitaty Faci(ities$1 dumpster;Site Work Permif for subd'nrisionsAarge projacts <br /> CORIMERCIAL AttacPi(�)comptete seCs of Buit�Fag Ptans plifs a Life Safet"y Page;�4}set of:Etsergy Farms.R-0-W Perznit tor new consWction. <br /> Miafmum ten('k0).working days after submRtal date. Required onsite,Construelion Plans,Stotmwater P{ans w!Siii Fence Installed, <br /> Sanitary Facliities 8 1 dumpster.Site Woric PermT for alf new projects.Alfcommercial requiFemeMs must meet compYance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERN SURVEY required for all NEW construction. <br /> Direcdons; <br /> Fill out application campleteiy. <br /> ��an¢,-u,Car,trq;orrsl3n bec3c oE ap,�!i:,ut:m.rco!eri:c� <br /> �=r�r�t-ra•f=e:.��:ssssv,:s^:;x'v�ra�tm:xssis--�:;:�c-.=.�-� ���:���s��c-+s��.<;,i:r'��_; <br /> " ;ventljtor'tfre�orihadar)on Power of,'�ttomey�tor the o�sieeP)wrould ba-5ottieorie'avdh'naTairz+erl Ietterfrom awner authorizing same <br /> aVER3HE COUNTER PERM1il7NG (copy af contrad caquicad) <br /> � " Reroofs if shingles Sewere Senrice tipgrades AIC Fences(PIoUSurvey/Footage) <br /> DrivewaysNot over Countar if on public roadways..needs ROW <br />