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I <br /> I.,ILy UI/-UPI I yr l Nub rCi I I I I L 1-%PPIn1t2UUII <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> Iiti€X€€ ``ff r- . I.I I QQ p'r <br /> Owner's Name 12Obtr OTIr� C{o Owner Phone Number <br /> Owner's Address 3 �(' is Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address 14 <br /> tt r� <br /> JOB ADDRESS U113 -gosswagd r LOT# <br /> SUBDIVISION Drjk-'ty0[0d LISt PARCEL ID# 0a-01CO -CA(-Q30O-00noo 0� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR B ADD/ALT u SIGN = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION 11400, <br /> 1 BLOCK = FRAME STEEL = <br /> DESCRIPTION OF WORK 1400. SQUAB. CRA966CUT XP u-o C AASUIA —z_ <br /> BUILDING SIZE I SO FOOTAGE HEIGHT <br /> L LILkL L-LL{L{L{LLL+LL,{LC[.CR.{LLL CLL k.L.L C L C{C LL LL{L{CICL L{LL LLL, <br /> =BUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> i <br /> ®MECHANICAL $ 4 VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY = OTHER �v <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> il#Ill 0 V#9 <br /> 0 11 Il <br /> il III f i f f i 41 f i III Il <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE RE;ISTERED Y/N FEE CURREN <br /> Address f�� �/i- License# <br /> MECHANICAL COMPANY 96CA `6`I'^ It)"6hglit <br /> SIGNATURE go� {`__� AA�• T RE-GISTI_RLD YIN FEL CURRENp YIN <br /> Address GID r"4 l�fl/ 1&,.,, License# CKC 1$1 3 3 411 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN <br /> Address License# <br /> Ittti€loll IWRATIS1€li1Y.Ii11111t"iI€€[I€€€i€I€Yfiis Ittattlls t€i111 €lt€.t <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&9 dumpster;Site Work Permit for SUbdlvlslons/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,Slormwater 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: I s I <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 Attomey(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(Plot/Survey/Footage) <br /> Driveways-Nut over Counter if on public roadways..needs ROW <br />