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ups-ruu-uuzu Ulry OT Lepnyrnnis rermit Hpplication rax-Clb-rcu-uuZ'I Building Department )ate.Received Phone Contact for Permitting �� . ) C1 /� Jwner's Name Pal ke li o ni C Cu rA )G{O c, Owner Phone Number Jwner's Address 2U�2 5• t'a,x i1 t`�ui C �V G��I f Q(� L Owner Phone Number Fee Simple Titleholder.Name / r Owner Phone Number Fee Simple Titleholder Address !A JOB ADDRESS -( Vdd -,c `// i li ZM,r &,S , 3 LOT# r SUBDIVISION 00,ILS �5c� PARCEL (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED M NEW CONSTR 8 ADD/ALT n SIGN = = DEMOLISH INSTALL REPAIR PROPOSED USE 0 SFR = COMM OTHER TYPE OF CONSTRUCTION II 11 BLOCK Q FRAME �' STEEL Q DESCRIPTION:OF WORK 4GCJ 610 n's fi �J�n 16 Fa-,m 1 / BUILDING SIZE - JL I l SQ FOOTAGE� HEIGHT .=BUILDING $ ��-J VALUATION OF TOTAL CONSTRUCTION F `TT 1,��;�D =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY = W.R.E.C. 5-a'-pu-ve. =PLUMBING $ �/ #64too ` �� MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION =GAS = ROOFING Q SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS I ■�/�/ FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREI< LZ/N Address �Olafl�S-. _ � G° �(l�i U/elG)l ,33T ` License# �/a 1., .Dl i ELECTRICIAN COMPANY SIGNATURE REGISTERED YIN FEE CURRE1% LILN Address 1 License# C6 PLUMBER COMPANY v � � SIGNATURE Ai REGISTERED Y/ N FEE CURREr, Address 3r33/j/,3-?tb 01,,A)f Fz--3 785' License# �2 C/LMTa _7- MECHANICAL COMPANY �CGrJ�S lliY /(/�I//1C(I II SIGNATURE REGISTERED Y/ N FEE CURREK LYj N i7Gn ( GtSw1,FL 3 q fPLO� License# 3 20 Address OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address 1030m,n) %G/7 11 R13 y License# �1,eu 111111 .1111I11111111I111I11111111111111111111 Bill 11.IIAIIII..111111I111 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects 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. Minimum ten(10)working days after submittal date. Required'onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements.must meet:compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ****PROPERTY SURVEY required for all NEW construction. ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ i ■ ■ ■ ■ ■ ■ ■ r ■_■-■ ■ r ■ ■ ■_■-■�_■�■ ■ ■ ■ r ■ ■ ■ ■ ■ ■ ■ ■ ■_ ■-■ Directions: Fill out application completely_ Owner&Contractor sign back of application, notarized If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW