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' ouuwny uapaiunona <br /> Date Racal 7 . Q _. a '� -90% <br /> / Phone Coefact>:for Permitting , <br /> M Ownar Phone Number <br /> C ;lEe/ <br /> Owrisc's Name - P. , <br /> Ownses Address.(•/ J ty+h 5i= 2 Owner'Phone Number. <br /> Fes Simple Titleholder'Name � Owner'Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION- PARCEL ID# <br /> - (OaTAiNEDFROtAPRoPERTYTAXNonCE)• . <br /> WORK PROPOSED .. NEW CDNSTR ADD/ALT SIGN Q" Q" DEMOLISH <br /> e INSTALL <br /> 8 REPAIR <br /> PROPO.SED`USE- 0 SFR a COMM OTHER <br /> TYPE''OFCONSTRUCTION' 'BLOCK Q `FRAME 'STEEC ,©. <br /> DESCRIPTION. WORK �. LEA / f D <br /> :Y <br /> BUICDING'SIZE �'SO 000TAGE�: :HEIGHT - <br /> QBUILDING <br /> L•T!���UON'OF.TOTAL CONSTRUCTION'. <br /> =ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY [� E.C. ��'�} <br /> [PLUMBING $ �J <br /> QMECHANICAL $• VALUATION OF MECHANICAL INSTALLATION <br /> ? t <br /> Q.GQS Q ROOFING 0, SPECIALTY= OTHER <br /> FINISHED"-FLOOR ELEVATIONS FLOOD ZONE AREA AYES NO <br /> BUILDER ��rr� COMPANY ( YID• <br /> SIGNATURE REGISTERED I Y'/ N:.V- :FEE CURREn T.- <br /> Address (iserrse;#' <br /> `ELECftiClAN COMPANY <br /> SIGNATURE REGISTERED Y J N FEEctiRREa : Y/N : <br /> Address` rLlcense# <br /> SPLUMQER�.:-. ,;� . � 'COMPANY'-,.` •. .. _ .. .. . <br /> IGNATURE'" I REGISTERED Y/-N.: FEECURREn: <br /> Address F <br /> MECHANICAL COMPAPiY <br /> '.•'SIGNATURE]^.,:rl"'� _.`. . . ... . '� �'. REGtS7EtED" ...YI:N FEECURgE�DY1N.j�— ... <br /> Addfesssr: UCense.#,(.. <br /> a2THER r COMPANY. .- . <br /> =SIGPIATWRE r^ REGISTERED Y1'N• FEcURRE� Y/N <br /> - .. <br /> Ba <br /> Rl*SIDENTtAL;;;"AttOs )PIZit P.,l@ns„ SsTs o3'Bal(dliig-laps;(1):"t bf Endrgy;Fokns;R O VY+F!etmi rnetiv,tonstnscUon;; <br /> ornMinlmurrt"tent(I)0)} �tfigrday3 at7a��u6mlNal Fate Required'onsite Coriskilcpori Plans Stoanwater Plans w!S(It Fence installed;' <br /> Sar3lt ry�FadptteF,,j iumpstAC!$rl(PtVaLork Psrinit for subd�v(�IDRs/fa!9@ Pro1Q <br /> a`COMMERCIAL AtMJch(2)�corrip�ete setd ofBut'iflthg Flails plus a Ltfe'Safety'Page;(1}set of Energy Forms.ft O-W Permit for new canstnzcUoa. <br /> Minimum ten'(10).working days after submittal date. Required onsite,Construction Plans.Stonnwater Plans w/Slit Fence.Installed, <br /> Sanita Fadlltles.&:1 dum ster.Site Wo. Permit fdkillrew; rd ects:All commercial requirements must meet compIlance <br /> �'.=SIGN;RERfd11T• "7ftl`arSt"(2)sets4f�p8iieeied�le%isi��+'I:`:-:�?;..:.• ., .' -.': , <br /> —PROPERTY SURt%EY requlrBd:(gr_ail, F S(construcUon._. <br /> =` Fill:.out application complatsly. <br /> ''Ownet?6;Conhactor:'sigit;bads of application,notarized <br /> If'ov4r.$2500;allotiee;of.CoMm.encement is required. (A/C upgrades over$7500) <br /> 7tgenC(fnf'ih8.tidntiactor)7�r^PowerrofAt[om ey'(fiir'the owner)would'tie sonieorie with notarized.lstter fmm owner authorizing same <br /> 'DUER 7ftE COtIItT R RERRli3TiN .-__....(coPy.Ofccntract;regotred)—.: <br /> a_ <br /> i'.Rergofs wstiirigles `Sewers .Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways Not over Counter if on public fdadWay4..fi6eds ROV7 <br />