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Building Department <br /> Date Received 5 a U�, v Phone Contact for Permitting <br /> Owner's Name Ge����� �e Owner Phone Number pI -L4 .7� �U <br /> Owner's Address S l J o 01-n U4 r I 1 5 Owner Phone Number F <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address r <br /> JOB ADDRESS 5-73 Q U V+ ZqA4h `3 V I 5 3 5` I -�k LOT# �� <br /> SUBDIVISION �r.1 �1'�` I l S PARCEL ID# ll-a -a oo�o. 3!`(b - o l('0. <br /> (OBTAINED FROM PROPERTY•TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN Q MOVE DEMOLISH <br /> El INSTALL e REPAIR f <br /> PROPOSED USE SFR 0 COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME Q STEEL 0 OTIHIEIR <br /> DESCRIPTION OF WORK lf <br /> CCLJ6 (e-(oUic. S C9It CPS �Q/� Sh[2, )eS <br /> BUILDING SIZE GOD SQ FOOTAGE HEIGHT <br /> 44. <br /> BUILDING $ VALUATION OF TOTAL ONSTRUCTION <br /> ELECTRICAL $ (} CJ AMP SERVICE PROGRESS ENERGY Q W.R.E.C, <br /> 0 PLUMBING $ <br /> i <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> GAS ROOFING SPECIALTY Q OTHER9/ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA AYES =NO <br /> j <br /> BUILDER COMPANY <br /> SIGNATURE I I REGISTERED Y/ N J . FEE CURRENT t YIN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURRENT Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# i <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License#' <br /> OTHER COMPANY � - <br /> SIGNATURE REGISTERED / N FEE CUR NT YIN <br /> / I- 2 <br /> Address 1p 6 U 5 ►\l S 33 License# LCCcl-.��.5ba <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(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 irfstalied, <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) j <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,* ry�Front of Application Only) <br /> Reroofs Sewers, Service Upgrades. ,. A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter:if.on public roadways.needs ROW - + <br />