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s��-7eaao2a Cit�of.�e�kr�r�ills Ferc�4t A��lica#ion Fax-a��-�e�-�aar <br /> ��r,;�.m,��ierr.irrar,- <br /> QateReceived. a �c� I l9 PfidneCorrtact�crRerm�tins f�c� y —d � <br /> -e-r�-e-ff-re-i- -- - T7-B's- - <br /> Owners Name ��'}i I S �- C Q Y"t A 1 1 / Owner Phone Number <br /> Owner's Address � Wv 3 �er Phone Number � <br /> Fee Stmple Tltleholder Plame Owner Phone Number <br /> �_��.-�:K�;;h:-hti=:Xtt�-''�"�[�=_f'+.�,'i;'€3"�- �'� 8 <br /> JOBADDRESS � � I'F� LAT# � <br /> susnms�oN �1 YC�XI parzc��o� <br /> YIIORK?RQPQSED NEw.c0lu5TR� ADD/ALT Q SIGN NEo FR�OM PROPERTY T�nce)DEPAOLISH <br /> � INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> 7YPE OF COi`dSTftU�TIflN �lECK � �P.AlY;� �: STEEL Q <br /> ' UESCRIPTION OF WORK `�`CQCSL d� l: <br /> BUILD�FSG SIZE '; S�FOOTA6E�` HEIGFtT �� <br /> BUILDING �VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> (�+��'^i:ilTABi�iG y5 � I <br /> I � � s� <br /> �MECHANICAL �S VALUATIOAf OF MECHANICAl1NSTALLATIOM � 4 � <br /> / <br /> ;�GAS � ROOFJNG .Q SP.ECIAL7Y.Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> ' BUILDER COMPANY � c�-i L�Q��+'d��-1�'�D 1� <br /> • SiGidAgklE�E !tEGtsTEitEO� . '!�i Pf- rcE�T7�nER . '�ei1 . <br /> aad�� ( f3( (h�Us u�e#F '�.''�RB�I�1 �" <br /> � ELECTRICfAN COF1tFANY <br /> SEGPIAFURE REGISTERED Y/ FV FEE cU� Y/AF : <br /> Address - License# <br /> PLUMBER , COMPANY � <br /> SIGNATURE �Glsrer�o Y/ N FeE Cutu�n Y/N <br /> . <br /> , ,.. ,�.� <br /> r'v:%6;�-e�s_ -d �x�� � <br /> MECH/WtCA! COMPANY <br /> SIGNATURE ��Isre�o l'1 N . rt�Ctr�tEn < Y/N <br /> Address License#� <br /> LiTflER CO1dPANY <br /> SIGNATURE REGISiEREo Y/ N . �cursr�En Y!N <br /> Address License# <br /> � -�',��'.��3.. _ F�:.. ,. r �.';s. ..�e..,"5.5...��.a�3.:.- y:..r.f�-eM1a "�''�E��.4•:Er. '3'�i�A.�'�__"__ �-,Fy3,.av.'��.���," <br /> ' _ _ .�. _._, .. _ .; _ 4�_ . <br /> RESIDEI�FTIAL Attach(2).Ploi Plans;(2)sets of Building P(ans;(i�set of Energy,Forms;R-O-W Permit foi new.construction,. <br /> �nimum ten('10}wor(cing days affer se6mittaf date. i7equired onsita;Cunstrudia�Pfans,S�emnwet�r Pfaes-w!Sd[Fence irrsta(Ieff, <br /> San'ctary Facili6es�,t dumpster,Site Wock PermR far suhdivisionsllarge prajects <br /> COMMERCIAL Attach(2)complete sets of Buitdirtg Plans plus a Lite Safery'Page;�i)seLaf.Enecgy.Encros:R-Q-W Fertnit for new conshuction. <br /> Ivtinimum ten(14}working days aRer submiita!date. Requiced'onsite,Construction Ptans,Stormwater Plaqs w/Silt Eence installed, <br /> Sanihary Facilities&t dumpster.Site Work Permit tor alf new projects.AII crommercial requfrements must meet compiiance � <br /> SIGN PERMIT Attach(2)sets oF Engineered Plans. <br /> "'•PROPERTY SURVEY required far all NEW cronstruction. <br /> Directlons:• . <br /> Fill out appiication campletely: <br /> �•ner�Cor.uactor s yn�E.^,.k 3`app:i:�'.�n::s3tter.:td ' <br /> "Y};fi�'.�t"t�}'=.�hY.+:Y.�-::<9;Xs.:€'k-:3.��>:fi::-.t+r'.&S�r:x'i:'� �ilPL3i„Y�:.?t:i.s5.[;ka??:_�.l:�i%%.._ , � <br /> " Agent'(hx'�e conlracTaYj or Power oY Ariortrey�for the anm�f)tivoaiiffd'be�ortieone u,ith rrotariz�llet�rfimm owner aulhori�mg same <br /> 'DVER THf COUNTERPERNll7T1NG {wpy of contract required) , � <br />� Reroofs if shingles 'Sewers Service Upgrades A!C Fences{Pb�SurveylFooYage) ' " ' <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />