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Building Department <br /> Date Received <br /> a a o3 Phone Contact for Permitting <br /> Owner's Name eTfi.(� ��� �� l`-� Owner Phone Number I a� - 3 ` _7 <br /> Owner's Address v BOX Oa� f 1 '1 MS l" Owner Phone Nu ber <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> C9 l-7 �p p.� In ,n I I <br /> JOB ADDRESS �b S l 1 m "`" V, ( ' `,�l S ` 3 3 5`I LOT# <br /> SUBDIVISION Utl)�l O+ I'll 1S PARCEL ID# (- tIJ-� J Uo i V` . q do- C,t(o 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR R ADD/ALT SIGN 0 MOVE Q DEMOLISH <br /> INSTALL REPAIR j <br /> PROPOSED USE 0 SFR 0 COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME / STEEL Q OTHER <br /> DESCRIPTION OF WORK covow ife 7�o / I.)U Ua(eS CV 4 t'QS hq)� `I.II <br /> BUILDING SIZE SQFOOTAGE /ac, o HEIGHT a._SIU <br /> BUILDING $ C� a A 1 VALUATION OF TOTAL CONSTRUCTION i <br /> 0 ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.G, <br /> Q PLUMBING $ <br /> 0 <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> 0 GAS Q ROOFING 0 SPECIALTY OTHER <br /> i <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES QNO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED i Y/ N FEE CURRENT Y/N ' <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> .i <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N 'FEE CURRENT <br /> Address License# i <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> I <br /> Address License# j <br /> OTHER / {M COMPANY I i= '1 I TnC <br /> SIGNATURE e ��pp �• S,r REGISTERED / N FEE C RENT/� /N <br /> Address 131413 U(r- S 4 Its t�� 3 331 License# �LCC <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,Construction Plans,Stormwatier'Plans w/Silt 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 ten(10)working day's_after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Facilities&9 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 Commencement is required. (A/C upgrades over$5000) i <br /> ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing 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 />