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i <br /> ts�a-ieu-uuzu City of Lepnyrnius Permit AppllCatiOn rax wa-rou-vuc i <br /> Building Department <br /> S <br /> Date Received = <br /> �. :Phone Contact:for•Permitting.,, I3 - 5 19S <br /> Owner's Name (a1GU SEAAi MCK ljeow Cw&!!. Owner Phone Number , 8/3—78 -3596 <br /> 39036 GT4AC-G 04ftZ z SACS <br /> Owiner's Address'.' / Owner Phone Number <br /> t: <br /> ;; / A 1 * <br /> Fee Simple;Titleholder Name /r•�`f ' Owner Phone N i umber <br /> Fee Simple;Titleholder Address <br /> JOB ADDRESS ,512I I`q•)4 7--WI'l,5 LOT# �oi7i <br /> 11 <br /> SUBDIVISION: PARCEL ID#. I I—ZG-21�0610-20100-0000 <br /> i (OBTAINED FROM PROPERTY.TAX NOTICE) - <br /> WORK PROPOSED „ NEW CONSTR' ADD/ALT SIGN Q 0 DEMOLISH <br /> �' INSTALL 8 `REPAIR /�t10YI�1Jbr✓. <br /> PROP..OSED USE• _' SFR 0 ­COMM 0 OTHER <br /> TYPtOF CONSTRUCTION 0•. BLOCK Q. .FRAME . 0, STEEL =. � <br /> I, <br /> DESCRIPTION'OF WORK fjlOiwo <br /> BUILDINGsS ZE' P�A�✓g O� F�� SQ-FOOTAGE 2�2�. :HEIGHT-,:�-3�6 <br /> BiUILDING $��' VALUATION'OF TOTAL CONSTRUCTION` <br /> =ELECTRICAL $ ,/ AMP SERVICE 2pQ Q: "i?ROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING, $ <br /> =flIIECFiANICAL $ VALUATION OF MECHANICAL INSTALLATIONWO <br /> Gov <br /> =.GAS = ROOFING Q SPECIALTY. [� OTHER <br /> FINISHEDjFLOOR ELEVATIONS FLOOD ZONE AREA =YES NO' <br /> i <br /> BUILDER 1; COMPANY <br /> SIGNATURE REGISTERED I Y'/ N FEE CURREN Y•/N <br /> I' <br /> � I <br /> Address License:# < <br /> n.`ELECTRICIAN;'.,;.; COMPANY <br /> SIGNATURE REGISTERED Y/ N `FEE>CURRE� .. ' Y/N <br /> Address Licenser# <br /> f <br /> PLUMEEK _ ..COMPANY::.,: I <br /> 'SIGNAT RE REGISTERED`, •..Y/_`N. •.i ':FEECURREK Y/N <br /> "'. <br /> Address. License <br /> MECHI4P11CAL: : ::. .__ COMPANY <br /> r=:SIGNATURE''::'.'`.' " REGISTERED Y/ N FEE;CURREN. <br /> Addressv License.#', <br /> r: <br /> �'�-OTHER�`• '�y;;..:,�:':•;:= ... - ;COWIPANY: -I <br /> :,.. /N FEE CURREK SitaNATtJRE;r,t REGISTERED Y <br /> Addr®'ss ,_ ss> -License <br /> ,RESIDENTI' `l;--•!Attach-:2;°�Pf PP' :i • <br /> AL • ,. (_) of .aris';'j2)sets of ans;('1:)aet of,Ene 'Fom�§;R,0=V11 Permit for new,const fiction; <br /> >:; + MOM, .10, p. in ;da :$aftersutirn ttakilate.'Re uired'onsite,Construction'Plans'Sto .wat®rPlans'W.Silt Fence.'iris Iled <br /> _'•z,.xv-y�,,,� ;tl.S�. _ � - <br /> Sancta fFacllities `;1l.dwmpstet,aSif clNork:Permit":foF'subdivis'ions�a `er ro <br /> COMMERCIAL Atte'ch?2)'complete sets ofBuild(ng Plaris plus a life Saf®tyPage;'(1")set of Ehergy'Fomis.R=O-W Permit for'now construction: <br /> Minimum ten(10)working days after submittal date:-Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed,.. <br /> Sanitary Facilities star Site Work Permit for alhnevu; ro ects.All commercial re. uirements.must meet-com Rance <br /> :SLGN1PERAiIIT "Attach`( j sets of..Ej gineered;Plans :: �' <br /> ;. PROPERTY SURVEY required for..,eILNE. <br /> { _ W'constrLction... <br /> -_y G�Directions:: as.ata��`��Y�'<iJ3.�. ., • <br /> >`.Fill-outapplication completely. <br /> `O.wner&Contractor,sign:6ack of application,notarised <br /> `if:oVer.'$2500i.a:Nbtic®:of-Commencement is required. (A/C upgrades over$7500) <br /> Agent_(for'Me`contraictoe)=or-Power,of'Attomey:(foCthe dwiner)would"tie someone with notarized'letter,from owner authorizing same <br /> s, OVERTHE:COUNTER=P.Eilllf ITfNG„ (copy ofcontract required) <br /> r-. ..,u. <br /> R"r4dfs,if,s' ngles Sewers. "Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> :Driveways-Not over Counter Won public'roadways'needs`R01N <br />