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Fee Simple Titleholder Name hi� Owner Phone Number 3 7 � �1Sy <br /> I <br /> Fee Simple Titleholder Address Jo Z ( T <br /> _ jl � _ <br /> JOB ADDRESS 3� F /L/�}°vv �`�'� ?J �� LOT# <br /> SUBDIVISION PARCEL 10# Z Z.' -2A 0030 oo-:�Of, U I G Q <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R <br /> NEW CONSTR B ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL = <br /> DESCRIPTION OF WORK E1 <br /> BUILDING SIZE SQ FOOTAGE= HEIGHT <br /> BUILDING $ rl �® VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ o� AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . . ._._._L. �. <br /> BUILDER ( 1 �I � COMPANY ��• ✓C%�- ?� fti <br /> SIGNATURE REGISTERED Y/ N FEE CURREN 1 -YIN 11 <br /> 3r � <br /> Address /6 1- / /© License# Ccc/-3 3 0,972 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N_J FEE CURREN LY/N <br /> Address License# <br /> OTHER COMPANY L^iciCT c.�7to� <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# 1 d c L/ 3 3, O ef 7 2- <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 r3<1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(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£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 /> . . . . . . . . . . . . . . . . . . . . . . _. . . . . . ._._. ._. ._... <br /> ._ .s <br /> Directions: <br /> Fill out application completely. <br />