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Building Department <br /> ate Received '� �� - /v� JPhone Contactfor Permitting . ) q _- +I'J ( jam. <br /> �Irtrtr e-ate-® - _ <br /> /I l <br /> wner's Name �o c ���'U(l1 C N fA x'0`1 c. (,L Owner Phone Number <br /> r <br /> J <br /> wner'sAddress ��G�Z S' �GLlilb(ttG �l ' iV��bll2�t� L Owner Phone Number �r <br /> m Simple Titleholder Name /A Owner Phone Number <br /> m Simple Titleholder Address I A <br /> )B ADDRESS Lh /S �v LOT# D � <br /> UBDIVISION DOA-'SO VMCIP PARCEL ID# v Z/— — 2/ - 01 219-00000-0,R90 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> FORK PROPOSED a NEW CONSTR 8 ADD/ALT SIGN Q DEMOLISH <br /> INSTALL REPAIR <br /> ROPOSED USE ® SFR. F__J COMM OTHER <br /> YPE OF CONSTRUCTION 'EJ BLOCK 0 FRAME 'STEEL [� <br /> ESCRIPTION OF WORK <br /> UILDING SIZE SQ FOOTAGE �1" p�1~ HEIGHT01hD- <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> s. (� <br /> =ELECTRICAL Is 6 U q ,10 AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING Is /qn/00 J <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING SPECIALTY OTHER <br /> 'INISHED FLOOR ELEVATIONS al q n / FLOOD ZONE AREA OYES NO <br /> MILDER COMPANY a'fc (. <br /> iGNATURE REGISTERED Y/ N FEE CURREN p, Y/N <br /> Address 0��9i t�G� /id�+crC' l(/�/�/eC[)I�Li33J�� Licensse# <br /> ELECTRICIAN COMPANY cJkazla U et/_I a"l G <br /> )IGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address 1 , h [CG 7!- tV v 7) Q/rp L License# EC 1 3 00 7 5 <br /> DILUMBER COMPANY <br /> 5)GNATURE REGISTERED Y 1 N FEE CURREN <br /> Address 3/33/l/:r 2i Imo' �j r�Lc ,FL�✓LJr License# I I`?a7_:�7_7 <br /> WECHANICAL COMPANY /1)4C/7pS /fw (b-'VU�/•<< <br /> 31GNATURE REGISTERED Y/ N FEE CURREN L Y./N <br /> �(/3 I�GrLt67 1 fiZ1f� dSLY►,�L 3c/(P(a� License / 3 Address <br /> DTHER COMPANY <br /> / did PCIQJ fi <br /> SIGNATURE REGISTERED L_ILLN J FEE CURREN <br /> Y/N <br /> Address ���/n �f ' "�R, License# 6/3-�F g� <br /> tleA088 :0eeotl :e.tlaaaetltlatlaeatlegltlteAe99eunlltleaol< etleeea � oeQEYeflCetleeflanen <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 Fonns.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 />