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01.571ov_uuzu %.illy U1 L-UP1J}+tittl10 t ctisttar'its�ttvt,tava, <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> Owner's Name CL��� '}- Loy 1 V l n l n Owner Phone Number 13 - t 0(9 717 q5 " <br /> Owner's Address �� f- � 1 �S 'r Owner Phone Number -" <br /> Fee Simple Titleholder Name Owner Phone Number�- <br /> Fee Simple Titleholder Address <br /> (� / /( 2 `/ <br /> JOB ADDRESS 'tRpoleqol� i!{ ( c(t t�i _3 5`t D LOT# <br /> SUBDIVISION I UI Inc E'S TGt s PARCEL ID# c�- � -W 5A'-6WJ6 -1 C =t.b.- <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR e ADD/ALT SIGN Q MOVE DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR 0 COMM 0 OTHER <br /> TYPE OF CONSTRUCTION • [ (�, BLOCK FRAME y Q " STEEL Q OTHER ] <br /> DESCRIPTION OF WORK (fit .t� Q U� Si QS tl��� "t . 10 <br /> � <br /> BUILDING SIZE, SCI FOOTAGE HEIGHT <br /> BUILDING $ bb <br /> /I VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING <br /> MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> Q GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD <br /> "ZONE AREA DYES QNO <br /> BUILDER COMPANY <br /> SIGNATURE I REGISTERED Y/ N FEE CURRENT Yi /N I <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE " REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> OTHER C � ' I C� COMPANY <br /> SIGNATURE _ REGISTERED Y)/ N FEE CURRENT -Y N <br /> Address tQ t S�2 S (h t 5 t License# Ct 5<565 • " <br /> RESIDENTIAL Attach(2)Plat Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(16)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/Silt 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 contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> 'OVER THE COUNTER PERMITTING Front of Application Only) <br /> Reroofs Sewer 'i7"'' �yg"''. _,:+�,.,- ° F'r::cSt,`nv.s:'s< w,:.a:.":•..FS..,t;'^..,.'•cr:,!nn::e.:,.�a. <br /> • e`, ..;e`Se 'rrT,e"I��jaiTes""'°" `i4/C3. Fences(Plot/Survey/Foofage) <br /> Driveways-Not over Counter if on bbb'l'ic'roa ways:°ri eds ROW ,4 <br />