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Building Department <br /> Date Received _ I - `1 Phone Contact for Permitting <br /> S�, Eli zQbC�(�1 1 S� ( �,N lU(CJ)To� Owner Phone Number <br /> Owners Name <br /> Owner's Address SU55 SrL <br /> (K((S Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address ((_� C I I, I <br /> JOB ADDRESS Sg SS 1 1U S+' f l �U 1�,�S LOT'i <br /> SUBDIVISION lumen O� k f h���5 PARCEL ID# ��-��-a( -U�J�- v S o�U � oo�U <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED'- R <br /> NEW CONSTR e ADD/ALT 0 SIGN Q MOVE [� DEMOLISH <br /> INSTALL REPAIR J <br /> PROPOSED USE 0 SFR 0 COMM QOTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME 0 STEEL Q OTHER <br /> DESCRIPTION OF WORK 14tv U P Ot 5S tXTIn .on Flo Adc Lk) Moc ���c� <br /> BUILDING SIZE, SQ FOOTAGE HEIGHT <br /> 0 BUILDING $ dU -Ob VALUATION OF TOTAL CONSTRUCTION -Po <br /> a PecYruts '1 I�xxjh ready (f10ve o� <br /> 0 ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY W.R.E.C. <br /> Q PLUMBING <br /> MECHANICAL VALUATION OF MECHANICAL INSTALLATION C <br /> 0 GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES =NO <br /> BUILDER__ ... COMPANY_ <br /> SIGNATURE ( REGISTERED Y/ N FEE CURRENT Yi /N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> OTHER _ �13L ltl �XX - `-1 ` 'COMPANY �1 to �(�C <br /> SIGNATURE V" ll dd REGISTERED I ICY) N I FEE CUkAENT I /N <br /> p l� a <br /> Address SIC- 5'l ` ' 335 / License# LC CCO�55,65 • . <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&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL. Attach(3)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/Slit Fence installed, <br /> Sanitary Facilities&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 /> 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 over$5000) <br /> Agent(for the contra ctpr).o[.Power_of Attorney(for.the owner)would be someone with notarized letter from owner authorizing same <br /> 'OVER THE COUNTER PERMITTING" '(Frain of Application Only) Y <br /> Reroofs Sewers,, Service Upgrades. A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />