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e3§-760-oo2o City of Zeptiyfh111s Pe tTiiCApplicatiisp Face iao ooz <br /> Building Departmoid <br /> Data Receivoi! Z— Phone Confacf.for Peimitftn <br /> _�_L.�r_r._r_r.r..• rn`b-r <br /> Owners Name Owner Phone Number <br /> Owrioes Address g Owner Rhone Number <br /> fee Slriipto Tidotiolder Name �- Owner Phon$_Number .F_ <br /> Fee Simplo T1tleholdorAddress <br /> JOB ADDRESS 1 (9 • Sy <br /> LOT;# <br /> .. <br /> SUBDIttiSION PARCEL ID# - <br /> 109IN JED FROM PROPERTY TAXAOTiCE) <br /> WORK PROPOSED NEW CONSTR ADDIALT L' SION 0 = DEMOLISH . <br /> R INSTALL 8. REPAIR <br /> PROPOSED USE SFR = COMM E] OTHER: <br /> TYPE OF.CONSTRUCTION =_ BLOCK Q FRAME Q STEEL [� <br /> DESCRIPTION OF.WORK f 2- i r i dQ to N i A J Z.. <br /> $U1LD14d,SIZE :SCt,FOOTAGE HEIGHT �. <br /> UILDING S e VALUATION OF TOTAI,.CQNSTRUCTION M <br /> =ELECTRICAL �� AMP SERVICE. Q PROGRESS'£NERGY' <br /> =PLUMBING <br /> i <br /> =MECHANICAL (5� VALUATION OF MECHANICAL INSTi1lLA`riON <br /> =GAS = ROOFING =, SPECIAL'TY.= OTHER <br /> FINISHED'FLOOR E.;EVATIONS FLOOD ZONE AREA =YES NO <br /> . 1 <br /> BUILDER COMPANY �' )+�4 . (brYl CW t.zft 5: i.:L,L <br /> SIGNATURE REGISTERED FEE CURREn Y/N <br /> Address Po At,Y. Udense# 7 <br /> 32 �T Y> <br /> ELECTRICIAN COMPANY <br /> SIGNATURE ( REcisTEffaO I YIN FEEGURREt. <br /> Address License#�� <br /> PLUMBER COMPANY ( �..-. .. <br /> SIGNATURE �. .� RE.MTFRED I Y,/N ""'FEECURREi` Y0' <br /> Address license# <br /> MECHANICAL COMPANY �. <br /> SIGNATURE REGISTERED YII N FEECURREn <br /> Address License€�� t <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y1'H FEE CtiRREri <br /> Address License,#`.t <br /> S_f /..i.If11iItI`fI I'll vlIc1_IcIIIi_f.,f:.i:II3II.fIl "i,I,t-it_1ilt1I::1..1..I:1tt-I !.11t_IriitI7iI <br /> RESIDENTIAL Attach'(2)Plot Plans;(2)ssts,.of Building plans:(1),sgt oi:Enorgy Forms;R-O{AtO mi'itfornewconstrut on, <br /> Minimum ton(10),worRing'daysafter submittal dste; Requirbil orlsite.Con§Uuc6ri Plans;.Stomtrstar Plans,w/.Sill Fence insiall <br /> Santis Fodifities&'i.diirnpster,;Site We Porrn f(or'subd Ns(onsnarge pro)ecls <br /> COMMERCIAL Allach 12)complete sets of Building,Plans piu's a life Safety.Pege (1)set of Erierworms..R;O>W.Pbrmit.for rfew daislamlign. <br /> Minfrium I'en(10)working days'after submittsi date;Required:ensile,Conslruetion Plans„Stormwater Plans w/Siii'Fence Instoltod, <br /> Sanitary Facilities&1 dumpstar..Siie Work Permit loran newp'miects.Ali commercial requimmbMs must r6eet'comptiance <br /> SIGN PERMIT Attach(2j sets of Engtneeied plans. <br /> —PROPERTY SUi2VE r$quirod tor.as NEW construction. <br /> Directions: <br /> Fill out application complelely. <br /> owner&Contractor sign badVof application,notarized <br /> If over 52506;a,Noilca of Commencement is rgquimd. (AlC upgrades ovor$T500) <br /> Agent(for the WntraCldr)oYPowar bf°Altomey.(tor the owner)Would be'someone with notarized letier_from owner authorizing same <br /> OVER THE,COUNTER PERMITTING (cgpy.of contract mgutred) <br /> Rerooi6If shingles Sewers Service Upgrades.AiC Fences(Plot(Survey/Foolage) <br /> Driveways.Nof over Counter if on public raadways._needs ROW <br />