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uuuuniy uCNaniueiu <br /> Date Received g <br /> _ Phone Contact for Permittin ) (f/ <br /> + `-' it e= r z <br /> Owner's Name. <� r � t � . <br /> �L,• � Owner Phone Number <br /> 7. <br /> , r <br /> Owner's Address '� 1 f Owner Phone Number <br /> / non <br /> Fee Simple Titleholder Name Owner Phone Number- <br /> Fee Simple Titleholder Address /¢ <br /> JOB ADDRESS 7'DO _ ! • �; .l' ��G•' �� v(s '� I 'r �i- � ✓ LOT# <br /> r <br /> SUBDIVISION J PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW.CONSTR ADD/ALT = SIGN [] = DEMOLISH <br /> B INSTALL e REPAIR <br /> PROPOSED USE 0 SFR = COMMA OTHER -)j� <br /> TYPE OF CONSTRUCTION BLOCK 0 FRAME STEEL <br /> DESCRIPTION OF WORK j'` ��G'L�f /(i /lJ �r�G �G• ' J � jil �J <br /> BUILDING SIZE 0 !/l l� �D r ��/l SQ FOOTAGE OvC (Y HEIGHT <br /> isK 4.v.Er,Q.­'T �aEFEwtis a =sue r € rz. <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL q 1$ 84 19d AMP SERVICE = PROGRESS ENERGY = W:R.E.C. <br /> =PLUMBING $ q3O <br /> 7, <br /> =MECHANICAL $ 15 31 OO VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> J <br /> BUILDER. COMPANY d <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address [E�1k <br /> License# <br /> OTHER COMPANY (�� <br /> SIGNATURE REGISTERED Y/N FEE CURREN. Y/'N <br /> Address % .'I ( V�i� J' , - �'h License# �' <br /> fl @ © 9:fl9iE@@ .9II $ Uflfl . 9fl9tt L� ;= fl .9.fl9 € flflE99flZ, l? 99a Ef L.fl ? 99aflafl9Z_ E999_' 90 a a 9 a I <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 />