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fylo/v)C-A <br /> Date ffecolved Phone Contact for Permittlin SIB <br /> I_ , m -�i=�rrr"I <br /> Owner's Name 6-pto'-/ HOCK eR Owner Phone Number 'Y 0 1/- <br /> Owner's Addraso . 3197[,1 evetyd &Al Owner Phone Number <br /> Fee:'simple Tilleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 39'71q LOTV <br /> SUBDIVISION QAk e'AtS-r —OSf� PARCEL IDN <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRE] ADDIALT SIGN DEMOLISH <br /> E3 INSTALL REPAIR <br /> PROIPOSED USE SFR COMM OTHER <br /> rypr-OF CONSTRUCTION BLOCK FRAME CJ STEEL <br /> DESC RIPTION OF INORK 3 lf' ,n-P Viol k Loocj -Peon, _to.TA i die <br /> BUILDING SIZE I SQI:OOTAGE= HEIGHT <br /> � r1a==Q3zIX"x;" <br /> 4 <br /> [ BUILDING <br /> 5; VALUATION Oft TOTAL CONSTRUCTION <br /> (-7SLECTFUCAL AMP SERVICE PROGRESS ENERGY F-1 W.R.E.C. <br /> [=PLUMBING <br /> [=MECHANICAL VALUATION OF MECHANICAL INSTALLATION 1-or <br /> [_=GAS ROOFING SPECIALTY =] OTHER <br /> 'INISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> ttitH+t"t-ftH1-H+ft -1*H 1114 11111 hl 1 H1+1`tI 1 ht 111 1 H-H 611 11 <br /> WILDER tZ COMPANY 144ioiw.1ehs,,14ofne- Tf-irz s L.Lc <br /> ;IGNATURE ho_!t!J CAPAtto REGISTERED I YIN FEECURREII L_XLN J <br /> ,A,ddress PO 6e K 7'a 19 9 3 Q A r4 J cp ii L 3 7-9 61 License# 7 <br /> ;LECTRICIAN COMPANY <br /> IGNATUREREGISTERED FEE CURREN Y/N <br /> Address License 9 <br /> LUMBER COMPANY E� <br /> IGNATURE REGISTERED FEE CURRFII <br /> Address License 11! <br /> IECHANICAL COMPANY I <br /> IGNATURE REGISTERED _yLN J FEE CURREN I=N <br /> Address License# <br /> THEEC__` COMPANY <br /> IGNATURE REGISTERED YIN FEE CURRFh I YIN <br /> Address License It <br /> +f+Hti+"+" <br /> ESIDIENTIAL Attach(2)Plot Plans;(2)sets of Butlding Plans;(1)set of Energy Forms;R-O-W Permit for now construction, <br /> Minimum ten(10)working days after submittal date. Required onslto,Construction Plans,Stormwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&I dumpster Site Work Permit for subdIvIslonstlarge projects <br /> OMMERCIAL Attach(3)complete sets of Building Plans plus a Life Salety Page;(1)net of Energy Forms.R-O-W Permit for new cbristruction. <br /> Minimum ten(10)working days after submittal date. Required onsIlo,Construction Plans,Stormwater Plans w/Silt Pence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> GN PERMIT Attach(2)sets of Engineered Plans. <br /> *"*PROPERTY SURVEY required for all NEW construction. <br /> =t=123 1:xMxI:a1z1=n rrrr=lr rM <br /> factions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> lf•:)ver$2500,o Notice of Commencement Is required. (AIC upgrades ovar$7600) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> /ERTHE COUNTER PERMITTING (Front of Application Only) <br /> !roofs If shinglat. Sewers Service Upgrades AIC Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter If on public roodways-needs ROW <br />