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o 1 o-I ou-uucu Ully OT Lt)Pnyff III IS r-Uf f f l l I.IAPPI ICdLIUI I <br /> Building Department <br /> Date Received <br /> /� � <br /> Phone Contact for Permitting <br /> Owner's Name l J, 6!^r S6-1— O S(,-VJ Owner Phone Number �) 3 �J O 7 ✓�� <br /> Owner's Address 17 t 81LJ- ' Owner Phone Number <br /> Fee Simple Titleholder Name I Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 6�//v( <', 41 <br /> 9A_iIzil/1 LOT# <br /> SUBDIVISION Sal a4h' PARCEL ID# 05 , O oo?o 0300 0030 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED X NEW CONSTR ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER G LJd <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL EZ <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> ILDING $ (� VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ ( AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIO(P <br /> =GAS ROOFING = SPECIALTY = OTHER 3�D �(— -7 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ FEE CURREN I Y/N <br /> Address T FZ 33(�Y License# PC <br /> ELECTRICIAN <br /> SIGNATURE ` REGISTERED / N FEE CURREN Y/ <br /> Address l� Icense# <br /> PLUMBER U COMPANY 40 <br /> SIGNATURE �� REGISTERED I Y N FEE CURREN Y/N <br /> AddressZ.I­ 10 le, License# (::7 C <br /> -- <br /> MEG'fl74iQi�CAL __ COMPANY - - <br /> St6 l - -- - —- <br /> �� - —'- REGISTERED _ Y/ N -FEE CURRE�' Y/N Qi <br /> Address — --" - - ---- - L'icense# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N_j FEE CURREN Y/N <br /> Address I License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br />