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uity or/-ephyrh',Ils Permit Application Fax s1a-Tao-oo21 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> Owner's Name 1A. he�z lnc�- Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name E Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS (0 V-,01-,rj ke, ;7.,oil Lj ;1/S LOT <br /> SUBDIVISION 7;;4-4ARCEL ID# WID M%W 03(ol) <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRE] ADD/ALT SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL F <br /> DESCRIPTION OF WORK -L 7 <br /> BUILDING SIZE SQ FOOTAGE 19�%S,51 C---�H-EIGHT <br /> —rmr"TI 1 1 A I . I <br /> =BUILDING 1 ro- VALUATION OF TOTAL CONSTRUCTION,P )—U� I coo <br /> =ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANI'CAL ' $ OQ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ' ROOFING SPECIALTY F--1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> 4-16 i 11 x 111 11 111 1 11 11 11 111 111 11 11 11 111 111 u w 11 i <br /> BUILDER F /t 1 �� COMPANY I I -R- 4�-� i r\c. <br /> SIGNATURE REGISTERED Y/ N FEE CURREN YIN I <br /> W & <br /> Address License# ! 3 9C 2 <br /> ie <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED FEE CURREN Y/N <br /> Address I'S 06 3 License o 1S7 <br /> PLUMBER COMPANY S J) <br /> SIGNATURE REGISTERED Y/ N 'FEEICURREN -(/N <br /> Address License# CF C,I i Z 3- <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED 1_ 19/'N _I FEE CURREN I Y/N <br /> Address 1'5710� D>Sber License# ICA C-6 33 <br /> OTHER , COMP.ANY IQ HQ16410IJ '�06�-Os <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N — <br /> I —+[q3 3f �)e k� I cc S:3 <br /> Ad <br /> dress License <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&I 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 P errrilt for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/5Ilt Fence installed, <br /> Sanitary Facilities&I 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 /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <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-§qMq <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotfSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />