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Data Received I 321 IT phone Contact for Permitting <br /> Owner's Name Lorii.QQVTo IN i I&I5 I_ " Owner Phone Number <br /> Owner's Address �JV�P `a (� Ave' Kuk�(ki��S �� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number ' <br /> :Fee Simple Titleholder'Address' <br /> JOB ADDRESS 3�(��la VgVZ h r1/iil�S l I 33Sy2� LOT# i- ao <br /> SUBDIVISION 1(7 0� Z14 PARCEL ID# --u-3(val -6o(A 6•S t oo - Di 7 O <br /> (OBTAINED FROM PROPERTY,TAX NOTICE) <br /> WORK PROPOSED- NEW CONSTR e ADD/ALT SIGN = MOVE DEMOLISH ' <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM - _ -OTHER <br /> TYPE OF CONSTRUCTION BLOCK . = FRAME = STEEL = OTHER <br /> DESCRIPTION OF WORK' ��4YlOVe."ono1 '(f— LQ� I t�1,ndOwS . <br /> BUILDING SIZE �W S r SQ FOOTAGE HEIGHT <br /> BUILDING $ r I u O/, VALUATION OF TOTAL CONSTRUCTION <br /> t V 5 <br /> = ELECTRICAL. $ AMP SERVICE = PROGRESS ENERGY = <br /> PLUMBING $ <br /> = MECHANICAL . $ VALUATION OF MECHANICAL INSTALLATION 0Wd <br /> = a <br /> tali <br /> = ROOFING = SPECIALTY = OTHER z <br /> FINISHED FLOOR ELEVATIONS' FLOOD ZONE AREA =YES =NO: r <br /> -BUILDER_. ,." COMPANY R JCV) Ca13-6r,+I(;nSViC, <br /> �;Qa N �� '- - - ---- - <br /> SIGNATURE rr rr__ REGISTERED Y/ N FEE CURRENT Y N S/'Z-77 <br /> Address �0t�3 S� S�� (y\,415 �I. 335�4 License# J cJ <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURRENT Y/N <br /> Address License# -� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTEREDI YIN FEE CURRENT I Y/N <br /> Address <br /> 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 <br /> Address License# L 1 <br /> RESIDENTIAL Attach(2)Plat Plans;(2)sets'af Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, ' <br /> Minimum ten(10).working days after submittal date. Required onslte,Construction Plans,Stornwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1'dumpster,Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAL, Attach(3)sets of Building Plans;(1)set of Energy Farms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onslte,Construction Plans,"Stornwater 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 an public roadways:.heeds ROW <br />