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Building Department <br /> Date Received1 '8 Phone Contact for Permitting ` -- bq-: <br /> Owner's Name Q CJ W t t i QM 5 Owner Phone Number 47, •' " <br /> Owner's Address �� (`i � ( ' S t { Owner Phony Nuriz `� '-t (bsr UJ <br /> Fee Simple Titleholder Name Owner Phone Number ' <br /> Fee Simple Titleholder-Address (( <br /> JOB ADDRESS �}�� t� T (h LOT# �` <br /> SUBDIVISION UUI� {{�� C3(��l�10(1 PARCEL ID# —cp"c�i ' ()6 6 `ba('0 —00`.�.. <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT �� SIGN Q MOVE 0 DEMOLISH <br /> e : INSTALL REPAIR 1 <br /> PROPOSED USE Q SFR 0 COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK n Q FRAME I STEEL 0 OTHER -I <br /> DESCRiPTIONOFWORK le Fck IUIa`�'.�' 'te�{`�.�`}.;s <br /> BUILDING SIZE_ SQ FOOTAGE � HEIGHT- <br /> BUILDING $ t t�j C�t© � VALUATION OF TOTAL CONSTRUCTION <br /> 0 ELECTRICAL ($T AMP SERVICE PROGRESS ENERGY; C] W.R.E.C, <br /> 0 PLUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION \� <br /> GAS Q ROOFING 0 SPECIALTY 0 OTHER . <br /> FINISHED FLOOR ELEVATIONS- FLOOD ZONE AREA [ YES =NO <br /> BUILDER_.. COMPANY:: _... .. _.. _ . - --- - <br /> SIGNATURE { REGISTERED Y/ N FEE CURRENT Y( 1 N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N J 'FEE CURRENT <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT LY.LN J. <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# �� <br /> OTHER — ' - COMPANY t r <br /> SIGNATURE L t "" � REGISTERED / N : FEE C RENT /N <br /> Address �UU 1 J .S `t C s� T 1 S �r 33 5 License# LQC 133 550 c`-� <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(16)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence:iristalled-, <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-WPermit 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 /> j <br />