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City of7eo Permit Application Fa»88-780-0021 <br /> F � Building Department <br /> Date Receiv'ed 190 e_CkUC\)QiAk-Oa� di�-kcirtv-� CON) <br /> Phone Contact for Permitting <br /> Owner's Name (_Aw nc Owner Phone Number <br /> 33 -umber <br /> -Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NFW CONSTR ADD/ALT SIGN DEMOLISH <br /> En INSTALL F-1 REPAIR <br /> PROPOSED USE = , SFR 'COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK )I <br /> BUILDING SIZE sQ FOOTAGE ' <br /> =BUILDING VALUATION OF TOTAL CDNSTRUC�ON <br /> ' <br /> [:=-�2L�CTR|OAL ��P�ERVk�� �--1 PROGRESS ENERGY F--� YY.R.EC. <br /> �-_~ <br /> L7,,PLUMBING <br /> IICA VALUATION OF MECHANICAL INSTALLATION <br /> �--�GAG F—�� ROOFING ( | ' SPECIALTY OTHER <br /> OTMER <br /> ���� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [__]YES NO <br /> BUILDER COMPANY <br /> ELECTRICIAN e— > COMPANY . LS�Ag Eler+n <br /> SIGNATURE <br /> PLUMBER <br /> SIGNATURE REGISTERED 'FEE Wkf�tl\ YIN <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> Address � Uoenna# <br /> OTHER COMPANY <br /> SIGNATURE nsa|Snsmso _YJ_N_l Fesounnex L_y LN_l"' <br /> ' <br /> Address License# I <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(,1)set of Energy Forms;F,-O-W Permit for new construction, <br /> Minimum ten(iO)working days after submittal date. Required uns1to'Construction Plans,Shannvat rP|anav/8ltFonceinsta8od. <br /> Sanitary Facilities&Idumpatec Site Work Permit for oubdWvionsl|anqeprojects <br /> COMMERCIAL /tfaoh(4 complete sets of Building Plans plus n Life Safety (1)set of Energy Forms.R-D-W Permit for new construction. <br /> ` Minimum ten(1O)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumdsta:O8eYYorkPenn\tfora\|nowpnVocts./A\oommnrcialnaqu\reffiontnmuatmeetoomp|ianoe <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ^°**PROpERTY SURVEY required for all NEW construction, ' <br /> Fill out application completely. <br /> Owner&Contracior sign back of application,notarized <br /> If over$mson`a Notice of Commencement|srequired. (Ac upgrades over*75OO) ' ' <br /> � . <br /> Agent(for the contractor)or Power of/ttoma�(for the owner)would ba someone with notarized letter from owner authorizing same <br /> [N' BTHE COUNTER PERMITTING (copy of000�aoi�qu{red) <br /> Remofs if shingles Sewers Service Upgrades A/O Fences(P|oU8umoy/Fnotag4-^''^''` <br /> Driveways-Not over Counter ifon public modwoyn..needoROW <br /> ` . . .. � <br />