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y Building Department 7%�� <br /> Date Received vp�U Phone Contact for Permitting l�Sdl�i -- wV <br /> Owner's Name I 0 ITV .J 0a K Ko Owner Phone Number pl tD 7 0 <br /> Owner's Address " J 7 ULt b owtl e 0k n t' Or. Sol`(1,!S l..++ Owner Phone Number <br /> Fee Simple Titleholder Name i . <br /> Owner Phone Number <br /> Fee Simple Titleholder AddreCs�s/ 11 <br /> JOB ADDRESS J.tJ �{I� , {ltt t LOT# . ` v <br /> SUBDIVISION CI j tt 1 I-S I PARCEL ID# ' ` 'b�l.� �✓� t i/v - t✓! 96 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED " NEW CONSTR ADD/ALT �^ SIGN [� MOVE DEMOLISH <br /> H INSTALL R <br /> REPAIR j <br /> PROPOSED USE O SFR 0, COMM 0 OTHER <br /> TYPE OF CONSTRUCTION �j BLOCK [ ] FRAME STEEL OTHER <br /> DESCRIPTION OF WORK �Qf.tl {E—f0(� 'd ( S lore CAS �lkl S i -Fly 1bf d q- r Qk <br /> 0 1 <br /> BUILDING SIZE. --a. t t FOOTAGE <br /> BUILDINCs $ 2�7� VALUATION Or TOTAL CONSTRUCTION <br /> ELECTRICAL AMP SERVICE 0 PROGRESS ENERGY 0 W.R.E.0, <br /> r_7 <br /> 0 PLUMBING i <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> 0 GAS E _ ROOFING 0 SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES =NO <br /> 71._•._BUILDER_ ___. .- _ . COMPANY <br /> SIGNATURE ' - _ REGISTERED Y( / N J FEE CURRENT i f iV <br /> Address License# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y I N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT LILN J. <br /> Address ; License# �J <br /> MECHANICAL ; COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y I N <br /> Address License# 1 <br /> OTHER C/ // COMPANY I�Co. <br /> SIGNATURE tR 1. REGISTERED N FEE CU,RRENr N <br /> Address oq S SL'' t tr! S' License# .CC:ra 565. . . <br /> HH"H <br /> HHHHHHHH <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,Storrriwater Plans w/Slit 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 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 /> 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 I Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />