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Building Department <br /> to Received 1 Phone Contactfor Permitting <br /> vner's Name �ir.�tC L Owner Phone Number�� ��._�W "'✓��� <br /> Knees Address cl r2 S, FGL��C�11 ,t I G / t v t°�61 l Q(t� L Owner Phone Number <br /> e Simple Titleholder Name / A Owner Phone Number <br /> !e Simple Titleholder Address !A <br /> )BADDRESS ((/v {2C�d llG S l/� i�7 /%ll�/S �fi 3 2 LOT# oZ J <br /> JBDIVISION OwkS D II SI; PARCEL:ID# a q' <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 'ORK PROPOSED M <br /> NEW CONSTR 8 ADD/ALT SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> ROPOSED USE 0 SFR = COMM = OTHER <br /> (PE OF CONSTRUCTION BLOCK [= FRAME STEEL [� <br /> ESCRIPTION OF WORK <br /> UILDING SIZE r jC SQ FOOTAGE ���� ��J HEIGHTf <br /> =BUILDING $ �/�,�� <br /> VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL Is 51113 � AMP SERVICE Q; PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING <br /> =MECHANICAL is r VALUATION OF MECHANICAL INSTALLATION �c <br /> =GAS Q ROOFING Q SPECIALTY = OTHER <br /> 1NISHED FLOOR ELEVATIONS =56— FLOOD ZONE AREA AYES NO <br /> WILDER COMPANY <br /> )IGNATURE REGISTERED Y/ N FEE CURREN LY/N <br /> Address r'O��J��� /I`?iCre"A 71 rle(Vi ea)/ 3 License# a 6" .0l O <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> License# ce{ , �715 <br /> Address 71 DLUMBER COMPANY / �,�r�C-l�� <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address 3133/lf�?�"7 (l j W,ldal�;01FL- 74 License# C �a 7�7_7 <br /> MECHANICAL COMPANY ��C�`I/JS AY CI.���(1/�Iff6 <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address R/_S/5Grti t-077 PVtr'l a-! M, 3 q cP( 7 License# . .7/ 3 Z0 <br /> OTHER COMPANY <br /> {z a k,CIQ� <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address 14/7%in or 0 ea) C/fi /G/? "/Ft' License# <br /> tlRtlR88 .ReAl@RAeRRRReIeeRllle6l< ittltltleRetlaaaeBeileaeli[ fleREe1RR1ReRR ;ERRRR <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/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$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 />