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Building Department <br /> Date Received ( U a(� Phone Contact for Permitting U 3 22- 10Uq � <br /> Ownes Name 'Kw in 5an�'e- Owner Phone Number �! �' 0� <br /> r' <br /> Owner's Address l 3 I.I S+ 4���L 5 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> ?�i-� J <br /> JOB AD DRESS l FIB ST J1tI�S �! LOT# <br /> SUBDIVISION CJ T I �t �"I �l s PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN = MOVE = DEMOLISH <br /> e INSTALL a REPAIR <br /> PROPOSED USE 0 SFR Q COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL = OTHER <br /> }e�,� r�-r�a� a5.5 �A Fa if 5.�� (e f�`roia�, gthak_ OOL 11`./bW6t <br /> DESCRIPTION OF WORK a <br /> BUILDING SIZE. Sou SQ FOOTAGE HEIGHT ✓ (a ,S��P� <br /> BUILDING $ j) r_()q i ). O L V/V UATION OF TOTAL CONSTRUCTION - <br /> ELECTRICAL (l I`t AMP SERVICE PROGRESS ENERGY W.R.E.C, <br /> = PLUMBING $ 0 <br /> [� MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> L � <br /> 0 GAS 0 ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS" FLOOD ZONE AREA =YES =NOIf <br /> ' <br /> COMPANY <br /> SIGNATURE REGISTERED Y/ N J FEE CURRENT Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N J FEE CURRENT Y/N <br /> Address License## <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N. <br /> Address F77 License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address m License# <br /> OTHER ��/� A o COMPANY Mao`ao b t '�"� <br /> SIGNATURE �" ' '_/�� REGISTERED Y/ N ' FEE CU ENT Y N <br /> Address 3( (3 SrZ S �hc�ls ( 33Sy( License# L�+ � fahJ0�s <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,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities.&1 dumpster;Site Work Per 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 days after submittal date. Required_ onsite,Construction Plans,Stonmwater 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 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 /> Driveways-Not over:Cpunter,,if on 1ubl1&roadways.:needs ROW <br />