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0111-fau-uuzu L;Ity OT 4epnyrnins vermlt Application raa-o iovo�-w� <br /> Building Department <br /> i q <br /> Date Received <br /> Phone Conta�ct;for Permitting'" (o R 7 3 <br /> Owner's Name e - Owner Phone Number O l�3' 2� J / 3 b <br /> r ^7 ! r fi�3r gay 016(� <br /> Owner's Address �� ! � � T'z �l��lf Owner Phone Number <br /> Fee Simple Titleholder Name ! ,1 Arcleii Owner:Ph'one Number <br /> Fee Simple fTitleholder Address ��-I .S• �. 5"10 W, IAAALel Giver 4� 33 �C✓ <br /> JOB ADDRESS 3 ! �C /1 �� I ICJ LOT# <br /> SUBDIVISION PARCEL ID# nQ d O r dV <br /> } (OBTAINED FROM PROPERTY.TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR' ADDIALT [�' SIGN 0 Q DEMOLISH <br /> R. <br /> "INSTALL e REPAIR <br /> PROPOSED;.USE [Z] 'SFR 0 `COMM 0 OTHER <br /> TYPE°OF CONSTRUCTION' Q BLOCK Q+. FRAME Q. STEEL 0 <br /> DESCRIPTION OF WORK 2�C ve{ J �fA/I I �Gr'1 U r U Orl'r, .f �t e1 <br /> I <br /> BUILDING SIZE ( SQ FOOTAGE HEIGHT' : a,/ <br /> []BUILDING $ VALUATION:OF TOTAL CONSTRUCTION' <br /> D T <br /> �EL-ECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY 0 W.R.E.C. <br /> �� !, <br /> QR LUMBING $ 0 , <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION c <br /> QGAS ROOFING 0 SPECIALTY 0 OTHER <br /> ` FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> I ' <br /> :BUILDER ' COMPANY <br /> SIGNATURE REGISTERED Y'/ N FEE CURRE. Y/N <br /> Address License#' <br /> ::•`ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N .'I FEE-CURREN - .' Y/N. <br /> I <br /> I <br /> Address License# <br /> .:P.LUMBER.p 'COMPANY, <br /> -SIGNATURE REGISTERED 4 N, " FEECURREK Y/N <br /> Address License#' <br /> MECHANICAL COMPANY. <br /> SIGNATURE.': REGISTERED Y/ N FEE,CURREK <br /> Address,- License.#.. <br /> G�2 COMPANY e <br /> 1 <br /> :SIGNATlJRE3;r:'M; `P REGISTERED Y/:N FEE CURREN <br /> Addrd & .: C ns� e <br /> ..y_ <br /> :RESIDENTf• ;Attach':2.t'PlotiPlansry'2'sets of Buildlri PPaans 1 set of Ener' 'Forms`R-q_,W, Permit or'new.constiuction <br /> �N ,a;X; Minfmum ten(;10);.working?;d'ay5aftecsutirriittal:date:"Requiretl'onsite Cbn§tniction''Plans,'Sformviiater:Plans w/Silt Fence installed, <br /> ` Sanita.. Facllitles 8�«1 dum star SiteWork.Permit for_subdivisions/la a ro acts <br /> ry'� .. ." P rg. P 1.._ <br /> % C.OMMERCIAL Attach(2)compli3te"s'ets of'Buililing Plans plus a Life Safety Page;O)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 8�1 dum star Site Work Permit for.411l nemi.:projects.All.commercial requirements must meet compliance . <br /> ry P.: <br /> p<SIGN`PERMIT AtfaoFi=(2){sets:;ofEngneeredFlaris: ::- <br /> R*i*PROPERTYSURVEY.required_for.all,NEW.constructiona. <br /> "Yt•r _ <br /> Dlcectidns:. <br /> FIII:out:application.completely. <br /> 'OwwnerA-Contractor.sign_back of application,notarized <br /> If over.$2500;.a Notice.of.Commencement Is required. (AIC upgrades over$7500) <br /> Agent�(fdr`the>cuntracfor)°or Power.oYAttomey(for:the owner)would'lie someone with notarized letter from owner authorizing same <br /> 3-`OVER:•THE COUNTER PERMITTING., ,.,.: .,.(copy..of.contractxequlred) <br /> �:'Rero°ofs ifatiingles Sewers." Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> :Driveways Not over Counter if on public'roadways::needs'ROVN' <br />