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Building Department <br /> Date Received a �b 'p�Oa.� Phone Contact for Permitting <br /> Owner's Name 1 CU) WOL IS Owner Phone Number <br /> Owner's Address lD`��8 i Uxmoor 't r. t Y ,i is(I Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> :Fee Simple Titleholder Address <br /> JOB ADDRESS IQ.V 8 FoXlmoOt- (• {��l�S • 33S�4a I LOT# <br /> SUBDIVISION S IV6 00—us PARCEL ID# d3_a "a <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R . <br /> NEW CONSTR e ADD/ALT ��SIGN = MOVE [— DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM OTHER <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL 0 OTHER <br /> DESCRIPTION OF WORK eQ! oF�' .rC_rD6F .I�BS9 •GO QS half Ies R 10(o1q.(. ,5 lWwf c -UOL 101 ;1 <br /> /`Vh 5 4 is 16p-e <br /> V BUILDING SIZE SQ FOOTAGE Ldm HEIGHT'----------------------- <br /> BUILDING $ / p �]([ VALUATION OF TOTAL CONSTRUCTION <br /> = ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> 0 PLUMBING $ <br /> = MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> GAS = ROOFING = SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES ONO <br /> BUILDER COMPANY <br /> SIGNATURE I I REGISTERED Y/ N FEE CURRENT YIN <br /> Address License# <br /> ELECTRICIAN COMPANY I <br /> SIGNATURE REGISTERED Y/ N i FEE CURRENT Y/N <br /> Address License <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> OTHER v� COMPANY <br /> SIGNATURE V�.►!I n (( REGISTERED / N I FEE CUM ENT 1i Y/Nc C <br /> Address its I 335y ( License# LUDJ <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,Stormw l ter Plans w/Silt Fence installed; <br /> Sanitary Facilities&1 dumpster;•Site Work Permit for subdivisions/large projects i ..... <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 days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <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: f. . <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) <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 /> D6veviiays-06t over;Counterif on'public:roadways..needs ROW <br /> ,- ..j ;irL?. [; 41 • 71r;1 ; .'�f',i(tt:'' �' `,'i;fi'i:�,`:'�'4; ' <br /> tii Clf. _ vh: - ,,_ 3 � ` �:1�. r')i' t''t(�1, liC;• I. - <br />