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Buuomg uepartment <br /> Date Received I a I Phone Contact for Permitting <br /> Owner's Name )be `'d' geva l O 1 I�0,f Owner Phone Number <br /> Owner's Address I I5 d I I L<¢(lQ V` (h r I S Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address (� r <br /> JOB ADDRESS l oI ( '/y�III rl � Y1�I�S. I ���� LOT# �1 <br /> SUBDIVISION Umm�� Oil I PARCEL ID# I -9�-'�I 'blv� ��, 03I <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT �/ SIGN Q MOVE 0 DEMOLISH <br /> e INSTALL e REPAIR <br /> PROPOSED USE SFR 0 COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME 0 STEEL Q OTHER <br /> DESCRIPTION OF WORK eGUO �e-�(,�� Q�Ss "''J r m't`�l� .V . Ies FIB lb�a'y � L2��` a•S�(+� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> ------------ <br /> BUILDING $ )h O r VALUATION OF TOTAL CONSTRUCTION ' <br /> 0 ELECTRICAL $ I U AMP SERVICE PROGRESS ENERGY' Q W.R.E.C. <br /> PLUMBING $ <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ( �(p <br /> 0 GAS 0 ROOFING 0 SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES ONO <br /> BUILDER- . COMPANY <br /> SIGNATURE l REGISTERED Y/ N FEE CURRENT YI /N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# ' <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address F License# <br /> MECHANICAL COMPANY' <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# ; <br /> OTHER - COMPANY <br /> Imp Od(t, ��' <br /> SIGNATURE _2 II^ I REGISTERED N FEE RRENT /N <br /> Address' I3 Sn� 5 / ►I (V11ltS A335 1 License# L C�4D5565 <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 Ferice installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirem_ ents'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/SuNey/Footage) <br /> Driveways-Not over Counter if on public roadways-needs ROW <br />