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ass-iao-ouzo uny Ot Lepnyrnills Permit Application rax-aia-r°"-""`i <br /> Building Department <br /> 5 <br /> Date Received phone Contact1or-Permitting —' <br /> rrrrrrrrm <br /> Owner's Name Owner Phone Number <br /> v 3 �� -7 6av <br /> Owner's Address Owner Phone Number <br /> Fee SimpleiTitleholderName F <br /> Owner'Phone Number <br /> Fee Simple#Titleholder Address <br /> i <br /> JOB ADDRESS LOT# <br /> I - <br /> SUBDIVISION PARCEL ID#, <br /> { (OBTAINED FROM PROP.ERTY.TAX NOTICE) <br /> 'WORK PROPOSED NEW CONSTR' ADD/ALT Q SIGN Q Q' DEMOLISH <br /> R INSTALL. e :REPAIR <br /> PROPOSED:USE• = SFR Q COMM = OTHER <br /> TYPE':OF.CONSTRUCTION BLOCK 0 'FRAME = STEEL . <br /> DESCRIPTION OF WORK 'v / r r `e Gt—w—tz, J2,�t/ e <br /> BUILDINGSIZE SQ FOOTAGE� .'HEIGHT.• ` <br /> =. <br /> BUILDING $ d VALUATION'OF TOTAL CONSTRUCTION <br /> =E+LECTRICAL $ AMP SERVICE = PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =,M'IECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> i <br /> =.GAS 0, ROOFING SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> or <br /> j <br /> :BUILDER ! �� COMPANY <br /> SIGNATURE REGISTERED Y'/ N FEE CURREN Y/N. <br /> Address 'License it <br /> I <br /> ELECT,RI,CIAN. COMPANY <br /> SIGNATURE REGISTERED Y/ N FEErCURREt` • YT <br /> Address' - License# <br /> PLUMBER.G; COMPANY ' :.; <br /> SIGNATURE: REGISTERED - . Y.­/ N. `j FEE CURREn.- Y/N - <br /> Address License'#` <br /> .I <br /> -':MECHANICAL;` ,: : - COMPANY:. <br /> SIGNATURE'•'.'"' REGISTERED -Y/'N . : , FEE CURREn Y./N ' <br /> Add <br /> ress',; License.# . <br /> COMPANY <br /> IGNATURE ;.;_ REGISTERED FEE CURREK Y/N' <br /> Addridss• - Lioense <br /> i <br /> cRESIDENYIAL" <br /> _ tta�_(,), IotP._ans:(2•)secs-of'Biiilding Flans;(9)`sef of Energy Forms>R O=IIV Pemiifforn®w.construction;. <br /> aerie(10):._w",orking„lays aftersut niittai.date:_.Required onsltb;�� nstruction Plans,Storinwater'Pians w/Silt Fence.installed,. <br /> Sanitary;FacillUes;&1 dumpster,Site Work P..ermit forsubdivisionsllarge.projects <br /> �COINMERCIAL Attach°{2)complete sets of Building Pians�plus a Life SafetyPage;(I)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"fo�*.all'new:'projects.All commercial requirements must meet compliance <br /> :rSIGN}PERMIT -'Attgb) (2�sets;of Engineered i?lans +_ <br /> ;• ;; PROPERTY SURVEY required:,for.all,NEW construction: . <br /> ;Directions: <br /> Fill:qut application completely. <br /> 'OwneeA Contractor:sign.back of application,notarized <br /> If over:$2900;_a Notice'.of:Commencement is required. (AIC upgrades over$7600) <br /> Agent.(for'thiB'•contractot)�or°PoweT,'of Aftomey-(fdr ttie owner)would-tie someone with notarized letter from owner authorizing same <br /> 'J7 VER-.THE:COUNTER;PERMITTIN_G,;. ,,.-. ._(copy of contract;required) <br /> _. , <br /> r: Reroofs if sFifrigles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways:needs ROW <br />