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Building Department �f <br /> Date Received Phone Contact for Permitting ( ( Y✓ C <br /> Owner's Name A PA) 5_44J Tf 6 P ----re. Owner Phone Number <br /> Owners Address " J 3 2- 1<aa.VA1e& pl w-D Z/�Q Owner Phone Number <br /> Fee Simple Titleholder Name 2 L'I Owner Phone Number C <br /> Fee Simple Titleholder Addrreessp 457 (�j <br /> JOB ADDRESS ✓ [Z 3 D r/ t`e,,q-rS 4 tlE / Wy s y3�354 LOT## �Sn <br /> SUBDIVISION ���{«.�is PARCEL ID# 2(!Ci ` (/ 060 0 5v <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK 0 FRAME = STEEL = <br /> DESCRIPTION OF WORK 'MCC QG✓4-fi <br /> BUILDING SIZE SO FOOTAGE= HEIGHT r <br /> B LDING MfVALUATION OF TOTAL CONSTRUCTION <br /> 1 <br /> ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y 1 N FEE CURREN Y I N <br /> Address License# <br /> 11111111,11111111111111111111111111111111111111111111t11111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsliarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date" Required onsite,Construction Plans,Storrnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.Ail commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> —PROPERTY SURVEY required for all NEW construction. <br /> Directions:• <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />