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Building Department <br /> aji <br /> Date Received 3 pl�a Phone Contact for Permitting l �0 t� -- (o6-I q <br /> Owner's Name V l) . [aS n Owner Phone Number <br /> Owner"s Address 375,% U\1 Rid ( �t ( D(a& C(1_11R I Owner Phone Number -� <br /> Fee Simple Titleholder Name i Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Q- Ir L1 WO 4�t�1S. �4 —i. :' LOT# . <br /> SUBDIVISIONK �eS� CS�cs.� PARCEL ID# ()J��`� <br /> I' (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED' R NEW CONSTR e ADD/ALT SIGN Q MOVE F DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR COMM OTHERLU <br /> TYPE OF CONSTRUCTION 0 BLOCK r ( FRAME 0 STEEL OTHER <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE. �U _ . ' S4 FOOTAGE C! HEIGHT _. <br /> J 1 <br /> BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> 0 ELECTRICAL $ j ! i.� AMP SERVICE PROGRESS ENERGY Q W.R.E.C, <br /> 0 PLUMBING $ I � • <br /> i <br /> . MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> i <br /> 0 GAS ROOFING C] SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO <br /> F I .- <br /> _.._BUILDER__...— ..: _: _- COMPANY <br /> SIGNATURE REGISTERED [ Y/ N J FEE CURRENT <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT L11N <br /> Address License# <br /> MECHANICAL i COMPANY <br /> SIGNATURE i. REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> OTHER COMPANY �a O(J r ()C <br /> SIGNATURE _ 01 I REGISTERED / N FEE CURRE' . 1 N <br /> Address 5 7 t 3 3 License# <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 fen(10)working days after submittal date. Required onsite,Construction Plans,Stormwater 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 fen 00)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/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 backs 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) i. <br /> Driveways-Not over Counter.if on public, ways..needs ROW <br /> �. •;i1i..� 1. -. - .. .. •. <br />