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01s-fW-UUZU city of cepnyrnins vermlt Hpp ication rax-o'irrov-vuc <br /> Building Department <br /> Date Rec0ired <br /> ;Phone Contact:for•Permitting.' ��J� <br /> Owner's Name 2El O GL' y Owner Phone Number , <br /> Owner's Address'._ e �p�/ �`e- Owner Phone Number <br /> Fee Simple;Titleholder Name. OwneraPhone Number <br /> Fee Simpl®Titleholder Addre"re <br /> JOB ADDRESS 3 O 6 7 a •j1go-A -V� r��`��� �� LOT# <br /> x <br /> SUBDIVISION: PARCEL ID#. <br /> i (OBTAINED FROM PROPERTY:TAXNOTICE) <br /> WORK PROPOSED NECONSTFU ADWALT • .= SIGN 0 Q' DEMOLISH <br /> I W. B REPAIR <br /> PROPOSED;USE = SFR Q -COMM Q OTHER <br /> TYP50F.CONST*LICTiON: 0 BLOCK - 0. FRAME 0,. STEEL 0 <br /> !t <br /> DESCRIPTION"OF WORK: - <br /> BUILDING;SIZE` '2. 0� SQ,F001'AGE HEIGHT ,. <br /> 1� 26 �lZ <br /> =BUILDING $ ®� . <br /> VALUATION'OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ 'AMP SERVICE 'PROGRESS ENERGY W.R.E.C. <br /> .:, 0 <br /> =PLUMBING' $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =]GAS 0 ROOFING. SPECIALTY OTHER' <br /> FINISHEDI FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO. <br /> . <br /> .BUILDER COMPANY <br /> SIGNATURE REGISTERED Y'/ N. FEE CURKN L Y/N: <br /> Address License:#' <br /> ;, ELEC,1�qIM".. COMPANY <br /> .;='SIGNATURE REGISTERED Y/ N ' FEE CURREf• <br /> Addr®ss' License <br /> PLUMBEIt;_:. 'COMPANY <br /> . <br /> SIGNATURE . . REGISTERED . Y.-/'N, : ;.:FEECURREK YN. <br /> Address. License#; - <br /> :.:.,:. <br /> :MECHANICAL; .::COMPAN7.... <br /> :SIGNATURE":' REGISTERED Y/ N FEE:CURREN. <br /> Address-� <br /> . 'COMPANYgap <br /> REGISTERED Y, :N FEE-CURREN Y/N <br /> License# Cc'C�. 3lov r,RESIDENTlAI;a :, 'fiAttaeli- :=RIb=I?I"t arise 40 <br /> lans'(1`)setof,ErieigyFo s R,0=1(V <br /> rfn"�; errnit.fornew•co P,. nstiuc4ion.,:.,9_1: <br /> =:•- :,�.z-r,:-:. z�iJlipimu[rj r4enf(16 Fyyor)Cing:da:S;after ul rnittal=daite: Re uiredron§ite'ConstrilctiorrPians,Stoimwat®r°Plan"s w/Silt Fence installed; <br /> Sanita'� acilities` r.d, um §te.aSif,VKoii Permit:forsub'dlvis'ion lia"e` acts..= <br /> �:e ,.,� err - <br /> COMMERCIAL Atta'cli"'7)ccmpiete sets-ofBuilding Piai splus`a'Li'fe'SafetyiPage;(1)set of Energy Forms.-R-O-W Permit fbenew construction: <br /> Minimum ten(10)woWng days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed,... <br /> Sanitary Facilities&:1 dumpster.Site Work Permit for aliwnew•projects.All commercial requirementsmust meet compliance' ' <br /> SIP "Affably` sets of;Ejigi►tiered Flans:= <br /> ""PROPERTY SURVEY regui'ted:for ai1,NEW'construction:-' <br /> a'Diectiotis: <br /> 7111:0ut application completely. f` . <br /> r : "Q,wner. 'Contractor sigp:backofapplication,notarized <br /> .:..;. 'If Nbtioe:of:Commencement.is required. (AIC upgrades over$7500)' <br /> M <br /> , .; C. Rgent_(fortheticontractgr:)cor7Power:ofAttomey-(for"the owner)would-be someone with notarized'letter`from owner authorizing same <br /> s` OVERTHE:COUNTER'M1PERAAl7TLNG;..:.' :.(copy-ofcontract�required)' <br /> r.„•: 1 . <br /> ReiQofs:if;sfiingles Sewers. ServiceUpgrad'es A/C Fences(Plot/Survey/Footage) <br /> ;Driveways-Not over Counter if on public'roadways needs,,OW' . <br />