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uuttding Uepartment <br /> O 3 c� I U 7g "Date Received <br /> Phone Contact for Permitting <br /> Owner Phone Number <br /> Owner's Name 22 �,(�1 In r . <br /> Owner's Address �J v� `°t " 'I IIS r� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number ' <br /> Fee Simple Titleholder'Address <br /> JOB ADDRESS C I LOT <br /> SUBDIVISION Ct� 0� z +��5 PARCEL ID# .-(( D—al - Go�•�' - 0'S OOO ' u.I� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN Q MOVE DEMOLISH <br /> INSTALL e REPAIR J <br /> PROPOSED USE SFR 0 COMM Q OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME STEEL .' Q OTHER <br /> DESCRIPTION OF WORK rmovt 0—no last L W�n dow3 <br /> BUILDING SIZE . �W$ SQ FOOTAGE L HEIGHT <br /> BUILDING $ f i ) O VALUATION OF TOTAL CONSTRUCTION <br /> 0 ELECTRICAL $ 'i AMP SERVICE 0 PROGRESS ENERGY W.R.E.C, <br /> 0 PLUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION Gam/0-6 <br /> - <br /> 0 ER l. GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS- FLOOD ZONE AREA =YES <br /> .._ I_BUILDER__ l m <br /> SIGNATURE �fflq� <br /> C) ' <br /> REGISTERED Y/ N FEE CURRENT Y_,Y N j i <br /> lip <br /> S I I^ <br /> Address �D't �3 �Z S�� Y (k14) C I' 33 S L� ( License# Z5,t Diu <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# L . <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 subdivisions/large projects <br /> COMMERCIAL, Attach(3)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 all new projects.All 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$5000) <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 (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over.Counter if on public roadways..needs ROW <br />