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u ru-r uv-uuw %al Ly UI LG(JI lyl t I111.b r-W 11 lit/APPIIL;dtIUI l ran-v w-r vv-uvt i , <br /> Building Department <br /> )ate:Received io Phone Contact for Permitting ` , ) a — . <br /> 1-iTrI-1Tt - <br /> )wner's Name PLj kt &)IY1L Conn. ct-n L Owner Phone Number <br /> )wnees Address 2U-2 S, Fal4aburc d/ i trrjj Owner Phone Number <br /> 'ee Simple Tit(eholder Name { Owner Phone Number <br /> °ee Simple Titleholder Address /A <br /> 106 ADDRESS J J lU �J I J✓ ^ LOT# <br /> iUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NORK PROPOSED NEW CONSTR ADD/ALT SIGN O Q DEMOLISH <br /> e INSTALL 8 REPAIR <br /> IROPOSED USE 0 SFR 0 COMM OTHER <br /> PYPE OF CONSTRUCTION BLOCK .0 FRAME STEEL = <br /> )ESCRIPTION'OF WORK lVt k) vOn s-t r UGA M - Sin le Fa-,hi t i'/Ll <br /> F <br /> WILDING SIZE SQ FOOTAGE HEIGHT - t f <br /> i <br /> =BUILDING $ D VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL J$ ®� AMP SERVICE = PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ fy r <br /> =MECHANICAL $ L TO=A VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING = SPECIALTY = OTHER <br /> =1NISHED FLOOR ELEVATIONS �/' FLOOD ZONE AREA AYES NO <br /> 3UILDER COMPANY <br /> 31GNATURE ,,/ REGISTERED Y/ N FEE CURREn Y//N_ n <br /> Address &kA5-, lelq ,ivex�lew,rti:33Tg License# <br /> =LECTRIC(AN COMPANY kdy_ A <br /> 31GNATURE REGISTERED Y/ N FEE CURREENN�p Y/N <br /> Address l pqnvl� , ` License# <br /> PLUMBER COMPANY <br /> 31GNATURE , REGISTERED YIN FEE CURRE� <br /> Address. 313��V� Ij lNflGt f��L�1,�785'� License# C 6 l ya 7a_-7 <br /> MECHANICAL COMPANY lmlt I Al� ' hmtt f,. <br /> 31GNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> G(l3 nc.►-rarl A71! dstrl FL 3�l t�(�? 3 ZT� <br /> Address LicLicense# � y� / <br /> DTHER COMPANY w• lnsse coe/ �a <br /> SIGNATURE REGISTERED Y/ N_J FEE CURREN Y/N <br /> Address 1431 Afvll) Ar D %G/1 Ri 3 License# <br /> : 1111i111111.I111lIIIIIIiIllilllll1111l111111111 ! llllllllllllllfllil <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 /> . . . . . . . . .- . . . . . . . . . . . . . . . . . <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. (AIC.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 />