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Building Department <br /> Date Received f I -( [ Phone Contact for Permitting V V�z <br /> It'll �f <br /> O I �-r Owner Phone Number �I11 <br /> Owner's Name a t r �?3t t.� t <br /> Owner's Address 14 W) {1`1(5 y h (hI I!S t' ! Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder-Address <br /> JOB ADDRESS t !,41(5+ ' TO&Ir w it LOT <br /> SUBDIVISION mobl �-s ��(�� PARCEL ID# O"O�I ' 5016 ' 63 bob• Oa 1.: <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN MOVE Q DEMOLISH <br /> e.I INSTALL REPAIR J <br /> PROPOSED USE F-11 SFR 0 COMM 0 BIER <br /> TYPE OF CONSTRUCTION i BLOCK FRAME STEEL OTHER <br /> DESCRIPTION OF WORK �1� t fC'r �C Sq G�t GtiS�t Kb{I t���tK�e Fl�`lbla`!.1 .5��� +C.UaL:.F('�!01�a 6•� ` <br /> BUILDING SIZE_ SQ FOOTAGE L HEIGHT 3IIa V loP� <br /> BUILDING � g�t_ Q 0 VALUATION OF TOTAL CONSTRUCTION <br /> 11 W4 <br /> 0 ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY W.R.E.C. <br /> PLUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I <br /> i <br /> GAS ROOFING 0 SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS', FLOOD ZONE AREA DYES =NO <br /> COMPANY <br /> SIGNATURE i i REGISTERED Y/ N FEE CURRENT Y J N r <br /> Address License# <br /> ELECTRICIAN I COMPANY <br /> SIGNATURE ( REGISTERED Y/ N FEE CURRENT Y I N <br /> Address ( License'# <br /> PLUMBER i COMPANY <br /> SIGNATURE j REGISTERED Y/ N FEE CURRENT Y/N <br /> Address i License# <br /> I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT L=N <br /> Address ? License# . <br /> OTHER COMPANY MOA K664ol J1'_- <br /> SIGNATURE _ v` v REGISTERED Y/ N FE URRENT I N <br /> Address 13 S K 'S ti (h r t! License# t_"�'C l�j.a�so�. Ll <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 tenj(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 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 tent(10)working days after submittal date. Required onsite,Construction Plans,Stormwafer Plans wi 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 Commencern' ent(s 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 aut orizi'ng`same <br /> 'OVER THE COUNTER PERMITTING (Front of Application Only) _ <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) ' ..•. <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> • i <br /> i <br />