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o io-Iov-uvzv LAY OT LepflYf ins f'ermll:Applicavon rax-o io-tau-uuc i <br /> Building Department <br /> )ate Received Phone Contact for Permitting <br /> L_� <br /> Jwner's N ;Pame o it lion-- GUM )Cu)c;' L L G Owner Phone Number <br /> 7wnees Address 2L 2 S, Fa l4obttl L / "ard f2o Owner Phone Number <br /> Fee Simple Titleholder Name /A Owner Phone Number <br /> Fee Simple Titleholder Address 1A <br /> JOB ADDRESS i J'l�� LOT# <br /> SUBDIVISION OWw " PARCEL ID# 6!--A&��[`��✓��� ` �"'�' <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED ® NEW CONSTR e ADD/ALT = SIGN = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE XQ SFR. 0 COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME 'STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE ! SQ FOOTAGE HEIGHT [- ` <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ / D® AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C, <br /> =PLUMBING $ <br /> =MECHANICAL Is A 0 VALUATION OF MECHANICAL INSTALLATION �I <br /> =GAS = ROOFING Q SPECIALTY .= OTHER <br /> FINISHED FLOOR ELEVATIONS /aD �� FLOOD ZONE AREA =YES NO <br /> (/� <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN/}//aY/N_ <br /> Address ��OC'0�� � /i��iCrC" r(��/�ielc�lr�%3 License# ba' (/Y .0l5r <br /> ELECTRICIAN COMPANY ka& l Y/4_- <br /> SIGNATURE }REGISTERED Y/ N FEE CURREN Y/N <br /> Address ! /� / �, �/ J L License# Cd l -�J-7 `J <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N _J FEE CURREN Y/N <br /> Address 313��u 37 �,l�t/G�Gi iFG3L�7S5 License# C 6/L/a 7a _7_7 <br /> MECHANICAL COMPANY 1�IZ46 A! & kM&f� <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> ! /3 DerntaYl/!V R5Za1,FL 3q(o(�-7 License# 3 2(� <br /> Address ens / <br /> OTHER - COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> llg3livin !fir Ofi /�Il 1=�,3� <br /> Address i License# <br /> 11111111116AlIIIIIIt11At111 ; 1111111tIt1111t1AlAlI1111t11111t11I1111 <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 Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(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 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 /> .■ • ■ ■ r ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ . ■ ■ ■ ■ ■ ■ ■ ■ ■ e • ■_■_■ ■ ■ ■ ■ _■_■ . ■ ■ ■_■_■ ■ ■_-■_■ <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$7500) <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 (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PloYSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />