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Fo»D18�8O��� <br /> [���ph�\Us Permit Application <br /> � Building Department <br /> Date Received Phone Contact for Permitting ( —— <br /> ' <br /> nuxvmm " " " . " . <br /> Owner Phone Number <br /> ownarmAd P— Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple TltleholderAddress <br /> � <br /> auBorwsmoN pxmoELOD# <br /> (OBTAINED FROM PROPERTY TAX—NOTICE) <br /> — <br /> WORK PROPOSED E5wavooms�n Aoo6ALT F---1 a\oN �—� F--\ DEMOLISH iN8T�LL R <br /> REPAIR <br /> PROPOSED USE �--1 apn [--1 COMM F---1 oTMER <br /> TYPE OFCONSTRUCTION � BLOCK �—1 FRAME F---1 STEELBUILDING SIZE F_ SQFOOTAGEF HEIGHT <br /> F--� <br /> DESCRIPTION OF WORK <br /> ' <br /> =BUILQ|NG r <br /> VALUATION OF TOTAL CONSTRUCTION <br /> F--�ELEOT�C4L �NPGEFV4CE �--1 PROGRESSENERGY �—� Yv.R.E.C. <br /> ��� <br /> =PLUMo}NG <br /> =MECHANICAL IS- 00 VALUATION OF MECHANICAL INSTALLATION <br /> =GAS E�K ROOFING �—1 SPECIALTY OTHER <br /> OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED 0lN1 FegooneE� [y/N I <br /> Address Ucenso# <br /> ELECTRICIAN COMPANY <br /> . SIGNATURE msGoTseso ^ rEEobnesN <br /> Address Jb6as RW, Uoanmn# <br /> [EE 0 039-13- <br /> PLUMBER COMPANY <br /> A . 5chkwnn <br /> SIGNATURE REGISTERED �^ <br /> '�ssb��n <br /> Address <br /> MECHANICAL <br /> SIGNATURE REGISTERED " FssoonRs^ <br /> Address License# L(A cc 33 �� 5 <br /> OTHER COMPANY <br /> SIGNATURE nse|eTcnso pEscueRE^ ` <br /> xudrm, 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 /> Minimum ten(1D)working days after submittal date. Required ons|0a.Construction Plans,Ghonnvater Plans v/Slit Fence installed, <br /> Sanitary Facilities&1dumpatsr;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL /tfach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R'O4m Permit for new 'conntruo8nn. <br /> Minimum ten(1O)working days after submittal date. Required nnni0e.Construction Plans,8tonmvater Plans vl Slit Fence installed, <br /> Sanitary Facilities&I 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 /> Fill out application completely. <br /> ovnsx&Contractor sign back uf application,notarized <br /> If over$25oV'a Notice of Commencement isrequired. (AC upgrades over$75OU) <br /> � <br /> Agent(for the contractor)or Power of/#tome�(for the owner)would be someone Withnotarized letter from owner authorizing oamu <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Remofs if shingles Sewers Service Upgrades A/C Fnnuoo(p|oVSuwey/Fnotage) <br /> ` <br /> Driveways-Not over Counter ifon public modwmyo..neodoROW - <br />