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in!. <br /> Building Department <br /> )ate Received Phone Contact for Permitting„ <br /> )wnees Name i? Owner Phone Number via - 71 <br /> owners Address -7 Owner Phone.Number <br /> =ee ;i`m. ple Titleholder Name Owner Phone Number <br /> °ae 5irnple Titleholder Address <br /> r LOT# <br /> JOB,,, DDRESSAve- <br /> sUBDIViSION PARCEL ID# IAAn <br /> - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NORK_P?ROPOSED NEW CONSTR ADD/ALT SIGN Q DEMOLISH <br /> e INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM OTHER <br /> TYPL OF.-CONSTRUCTION Q- BLOCK 0 FRAME STEEL Q <br /> glPnaN OF woRtt 0 U 5 Ze %ze O <br /> ,.,, <br /> E ti'111NG SIZE SQ FOOTAGE HEIGHT <br /> =t <br /> UILDING $ Qr1 I 8O VALUATION OF TOTAL.CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE PROGRESS ENERGY C] W.R.E.C. <br /> QPLUMBING S <br /> r <br /> =MECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> ; GAS 0 ROOFING Q SPECIALTY OTHER <br /> F It�',I SHED FLOOR ELEVATIONS FL000 ZONE AREA DYES NO <br /> ....,�..Y:. —1—r-1 a ■...•...■. <br /> 4=: gam <br /> BUILDER COMPANY Ce `5 L-L <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> .'Address C:'ft i`f .73 C10-J AW II iL License# tr -. y c <3 r-j t. <br /> 3; '9 7 <br /> ELECTRICIAN' COMPANY <br /> SIGNATURE REGISTERED YIN FEE-CURREN Y/N <br /> Address License# <br /> }I.;;,,ft1ER COMPANY <br /> ::prl:kTURE REGISTERED Y/ N FEE CURREN <br /> ;Address License.# <br /> MECHANICAL COMPANY <br /> SIGNATURE ( � REGISTERED Y/ N FEE CURREN Y/N <br /> Address: I License# <br /> OTHER COMPANY <br /> SICiP1ATURE _ REGISTERED Y/ N FEE CURREK Y/N <br /> Address License# <br /> "•�•�It1111litlIIIII111111111i11tIIIt1111E1111t1111tI11llllllilt11111 <br /> !vEtJ71At. 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 aHer submittal date. Required ensile,Constriction Plans,Stormwater Plans vd Slit Fence installed, <br /> r Sanitary Facilities&. t d:cnpster;Si!'WoSt t'e:nil for sutsdivisions/iarge pro;ec:ts <br /> 4..C,oi MERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1).s'et of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Requiredbnske,Construction Plans,Stormwater Plans w/Silt Fence instalied,• <br /> Sanitary.Facilities$ ;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 elver$7500) <br /> `*.. ;:Agent(for the contractor)or Power of Attorney(for the owner)would be someone with.notarized letter from owner authorizing same <br /> ;I�THE COUNTER PERMITTING (copy of contract required) <br /> ',Ir,i;:P7fe if shingles Sewers :Service Upgrades A/C Fences(Plot/Sulveq/Footage) <br /> .:: L)riveways-Not over Counter if on public roadways-needs ROW <br />