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.,..---- any U1 Z-VP iy1rnna rG1rIntr%NNnLduvlr <br /> Building Department <br /> )ate.Received 1 D— Z�2� Phone Contact for Permitting S ) a - 1"j- _ <br /> )wner'sName I'i.tl�C � D(11L (�0fd�Xt.0L' Uri Owner Phone Number <br /> )wner's Address 2U�2 S, FQllce�burG �l i�e�bif2i� L Owner Phone Number <br /> ee.Simple Titleholder Name Owner Phone Number <br /> 'ee Simple Titleholder Address IA <br /> IQB ADDRESS LOT# <br /> >UBDIVISION OI/tiILS� PARCELID# V -OXCV 045700 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NORK PROPOSED ® NEW CONSTR R <br /> ADD/ALT SIGN O DEMOLISH <br /> INSTALL REPAIR <br /> 'ROPOSED USE 0 SFR = COMM OTHER <br /> YPE OF CONSTRUCTION JK] BLOCK FRAME STEEL = <br /> )ESCRIPTION OF WORK >'lc� ���5 UG�t n /C ra'm l ILI <br /> 3UILDING'SI2E SQ FOOTAGER", HEIGHT ; <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> .=ELECTRICAL $ P C�® AMP SERVICE = PROGRESS ENERGY W_R.E.C. <br /> =PLUMBING <br /> =MECHANICAL $ V VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> 9NISHED FLOOR ELEVATIONS O i I m FLOOD ZONE AREA =YES NO <br /> 3UILDER COMPANY � � f! C 0'Y''/' vZl-� <br /> 31GNATURE REGISTERED Y/ N FEE CURREN Y//N <br /> Address ���5� nr ll�/1/leu)l��3 License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE y REGISTERED Y/ N FEE CURREN Y!N <br /> Address / /� �, ` License# <br /> PLUMBER COMPANY <br /> SIGNATURE i�, ,lLn REGISTERED Y/ N FEE CURREK YIN <br /> Address 3133/j��3-7t" 1/1Jr1G�I' V'FL License# FC/qR 7a-- <br /> MECHANICAL O COMPANY 94/t, JS ,/'r <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Ri3 ncnt6Y1 A7ll, dsw7,QL 3L/�Ia License# 3�� . <br /> Address <br /> OTHER COMPANY r" C`✓ �` <br /> SIGNATURE REGISTERED Y/ N_J FEE CURREI` Y/N <br /> Address 1 Dr Ail3 License# L/3�15S 3 3 <br /> 11111111111111I1IIIIILII11111111111111t111111Illllilll'Ili � l. 11llll1111 <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/Slit Fence installed, <br /> Sanitary Facilities&1 dumpster:Site Work Permit for all new projects.All commercial requirements imust 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.$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(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />