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s10-nru-Uuzu L;Ity OT Lepnyrnills vermit Application rax-a is-ion-wc i
<br /> Building Department
<br /> Date Received �Q f� ;.Phone'C:ontact:for,Permitting.,, Z-
<br /> Owner's Name N ei la— /t. . O�FP� Owner Phone Number
<br /> Owner's Address lO/4 urn O4) 2) e L� Owner Phone Number
<br /> Fee Simplilitleholder Name OWner`Phone Number
<br /> Fee SlmpleTitleholder Address
<br /> ii
<br /> JOB ADDRESS �S1vD�:SG O.� G S7� �j rdJ� /�s' F� LOT#
<br /> SUBDIVISION: I PARCEL ID#.
<br /> (OBTAINED FROM PROPERTY:TAX NOTICE), . .
<br /> WORK PROPOSED NEW CONSTR' ADD/ALT Q' SIGN Q Q' DEMOLISH
<br /> f; e INSTALL e 'REPAIR
<br /> PROPOSED:USE = SFR 0 COMM 0. OTHER
<br /> TYPE'`OFCOPISTRUCTION� 0' BLOCK 0.. FRAME , STEEL Q. j
<br /> DESCRIPTION OF WORK " eola
<br /> BUILDINGi31ZE, Sl1`FOOTAGE HEIGHT ,. '
<br /> :,:r
<br /> =BUILDING $
<br /> VAL.UATION•OF TOTAL CONSTRUCTION
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<br /> ELECTRICAL $ AMP SERVICE :PROGRESS'ENERGY W.R.E.C.
<br /> =PLUMBING . $
<br /> =f1AECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> i
<br /> = AS = ROOFING: Q SPECIALTY. OTHER
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<br /> FINISHED)FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
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<br /> ,BUILDER o; COMPANY
<br /> SIGNATURE REGISTERED Y'/ N FEE CURREN Y/N
<br /> Address "License:#
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<br /> ,.;:`ELEC.•T.,RICI%tN. COMPANY .
<br /> SIGNATURE° REGISTERED Y/ N FEE>CtiRREN , ., Y/N.
<br /> i.
<br /> Addr®ss License:#
<br /> =P.LURABERi COlWPAFIY_ .:.:
<br /> 'REGISTERED': Y.-/"N. FEE CURREK - Y/.NJ'
<br /> Address License,#;
<br /> MECHANICAL: COMPANY
<br /> SIGNATURE' REGISTERED I Y F N FEE:CURREN: .: Y/i •.
<br /> AddressY%:°: ' jeense.#'
<br /> zOTHER�``��..:•;..:'�':; .. ,. ;COflflPANY: _,
<br /> ONAUR�,;y'.:, REGISTERED Y/N FEE CURREN Y/:N
<br /> Addr®ss.;•._ Ltoense#'
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<br /> ORES DE TI`
<br /> :.,;
<br /> N AL., Attachi'2,.,Rlet Plan"s'";'2,'seas?:o(Buildin`:Plans' 1 set'of Ene Fo s�R-O<V11 Po ' It 'r�new,consiiiiction,
<br /> _ '?°.:.�.. ..r:�.). -ag..�. ,�,�•. _�y,�_._:rm ,-..�,�,y�;tt':� :g'C'3i..ti:. � -�';ly -
<br /> ?; , ,;.;•; <:�;.,gMinirnurr stan;(1,Q) or)dng days aftetsuf iri'itfal date:'aRegfaired"onsite;Constnictiorr~Plaos,'StormwaterPlsns w/°Silt Fence:instilled;'
<br /> " Sanit$ryk'FaciliUes,�&14dumpste,SigkWork Fe�mit#orsybdivisions%large projects
<br /> '-''QD AMERGIAL Attacti,-.(-2)•complete'sets'ofBullding Plansph- 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,Stormwater Plans w/Silt Fence.installed, .
<br /> SanitaryFacilities&:1 dum ster.Site Work Permit for alhnewi=projects.All commercial requirements-must meet-compliance-
<br /> ass`, ..:. _ -
<br /> ,SION PERMIT "Attach(2j set"s q ,E 9irieered,i?lans:t._sr:"; :.;
<br /> ****PROP reguired'for:aILNEW construction._
<br /> . ..:.. ....
<br /> 4..r:.. .,, .. ..
<br /> :,Llirectlon's::
<br /> Filiout application completely.
<br /> 'Owner&=Contractor:stgn:backofappiibation,notarized
<br /> !a`' 'lf:over'$2500;.a NotiOe:of Commencement.is required. (A!C upgrades over$7500)
<br /> ., Agent.(for Co
<br /> would tie someone with notarized letter from owner authorizing same
<br /> ?OVER:THEOUN7ER'PERMITTL�IG:..:.; Co
<br /> ofcontract required):
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<br /> Rer4ofs:ifstiin les S®veers: Servlo6U re
<br /> des A/C Fences Plot/Surve /Foots e
<br /> Driveway s-Not over Counter if on ubli&M—idwa s:needs`.ROIN^
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