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~'^''""-vuzv ChvofZephV[hiUsPe[-nit4mpUCati Fa�8 878O�021 <br /> OD �a�u <br /> Building DepartmentDate Received Phone Contact for Permitting <br /> BUILDINGOwners Address 57-coo 7ti!:Z!�pa,k <br /> 143�—Owner Phone Number <br /> ee Simple Titleholder Name ��-IAIIIIV Owner Phone Number <br /> Fee Simple Titleholder Address <br /> SUBDIVISION �t4jgjr �A <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR' COMM OTHER <br /> TYPE OF CONSTRUCTION E-2— BLOCK FRAME STEEL <br /> . ~�. -- --'--"BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> ` �—�ELE[�FUCA� AMP 8ERVOE F--� PROGRESoENERGY �--1 YV.R-E.�� <br /> ��� <br /> =PLUMB|NG <br /> =MECHANkCAL VALUATION OF MECHANICAL INSTALLATION . <br /> ` =Gms ROOFING F—� � SPECIALTY [---� OTHER <br /> FINISHED FLOOR ELEVATIONS oo FLOOD ZONE AREA =YES NO <br /> BUILDER 3, COMPANY Inc <br /> SIGNATURE 01 ,_� I �sox�sneo i_�_L-�_] ~EE:u««E^ L-I /-N_� <br /> Address Loanu# <br /> -ELECTRICIAN compxmr <br /> SIGNATURE I eso/orenso L_I1_N_1 psscunnsx L_l��L_� <br /> Address 2ak I License# <br /> ,LUMBER COMPANY <br /> 31GNAmmG REGISTERED LY/ N I ICunnsx L(/N � <br /> Address License# <br /> *ECHANICAL CqMp4mT <br /> 3|GN/QURE REGISTERED ` L_V VN_� rsEounne^`v <br /> Address License# <br /> JTHER coMp/wmT <br /> nGNArURE aEa/arsnso LY/_N_J rsscunnsx LY/NL_> <br /> Addmss License# <br /> lES|DENTmL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(1O)working days after submittal date. Requirudonaiho.ConotruoUnnP(ars.OhonnwaterP)onavlGUtFonoeinstoUed, <br /> Sanitary Facilities&1dumpater Site Work Permit for aubd)via\ons/|angeprojects _) <br /> ,OMMEKCU\L Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy'Forms.R-6-W'Permit for new construction. <br /> Minimum ten(1o)working days after submittal date. Required onode.Construction Plans,Stonnvator Plans y/SIR Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> UGNPERM|T Attach(2)sets of Engineered Plans. <br /> =°°PRDPERTY SURVEY required for all NEW construction. ' <br /> Fill out app||catinncompletely, <br /> Owner 8 Contractor sign back of application,notarized <br /> n over*oaon^a Notice of Commencement isrequired. (/VC upgrades over p750n) <br /> ^ Agent(for the.contractor)m Power nfAttome�(for the owner)would ba someone with notarized letter from owner authorizing same <br /> x/ERTHE COUNTER PERMITTING (copy of contract required) <br /> �mofs If shingles Sewers Service Upgrades A/C Fenoea(PbUSumey/Fpotage) <br /> . p <br /> Driveways-Not over Counter ifon public modvays.oaeduROW <br /> ' <br />