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AgentDate Received <br /> Phone Contact fo g <br /> Owner's Name 0 ner Phone Number <br /> Owner's Address 0 ner Phone Number <br /> Fee Simple Titleholder Name 0 ner Phone Number <br /> Fee Simple Titleholder Address E <br /> JOB ADDRESS 7 9 OPQ5r- Afv LOT# /a: <br /> SUBDIVISION *JARCEL ID# <br /> TAII <br /> (OBT41NED VROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CON ADD/ALT SIGN DEMOLISH <br /> INSTALL'TRE REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF,CONSTRUICTION BLOCK STEEL <br /> DESCRIPTION OF WORK <br /> BUILDINGSIZE SQ FOOTAGE HEIGHT <br /> =BUILDING 1$ VALUATION OF TOTAL CO, STRUCTION <br /> =ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C, <br /> =MECHANICAL ' $ VALUATION OF MECHANIC L INSTALLATION <br /> =GAS 12� 'ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> COMPANY <br /> SIGNATURE � 0 <br /> ELECTRICIAN COMPANY _4m <br /> Address &,y License# <br /> COMPANY <br /> PLUMBER I <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> OTHER COMPANY C-D68-21cl KD&Pas <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,Con�ructlon Plans,Starmwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large pr�jects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)se ry =orms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after-submittal date. Required onsite, r�unZion Plans,Stormwater Plans w/,§Ilt Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All c mercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plens. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) <br /> r of <br /> _(for the contractor)or __ —A_—n—` ,(for the owner)would--someone_. letter from. <br /> OVEBTHECOUNTERPERMITTNG (copy cicontract required) <br /> Remofs if shingles 8awem Service Upgrades A/C Fences <br /> Driveways-Not over Counter ifon public roadwmyooeedoROW <br /> \ <br /> \ <br /> ' <br />