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13a0cmng Department <br /> Date Received r <br /> L&Phone Contact for <br /> O&N <br /> Owners Name Owner Phone Number <br /> Owners Address J 30(0 SAT-SUHL-h1q. Owner Phone Number <br /> Fee Simple Titleholder Name. Owner Phone Number <br /> Fee Simple TitleholderAddross I <br /> F-- - - 9P SJOB ADDRESS J44PHrL1, LOT# <br /> suacmstou F Pmcw,v#[12- -2&-ZI -OOLIO - 00300- ,61301 <br /> (CEMAINS0,FROM PROPEMYAKNOTICE) <br /> WORK PROPOSED R NEW cCm7E AODIALT rV� SIGN DEMOLISH <br /> INST <br /> ALL REPAIR <br /> PROPOSED USE =1 SFR r7 COMM r-1 OTHER I <br /> TYPE OF CONSTRUCTION = BLOCK 0FRAME = STEEL = I <br /> DESCRIPTION OF WORK ITNsT-ALLArToto or Q-oor -H0uAir1g7,A PZv So(-P <br /> BUILDING SIZE I i $0 FOOTAGE HEIGHT <br /> . .&BUILDING <br /> U1LOING 1521-11-1 :] VALUATION OF TOTAL CONSTRUCTION <br /> aoLECTRICAL ISio, gj"q AMP SERVICE Q PROGRESS ENERGY r7 W.KE.C. <br /> =PLUMBING is <br /> F7MECHANICAL 15 VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING SPECIALTY = OTHER (P <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY 1VTV17Nr ar v calq <br /> SIGNATURE REGISTERED I Y/ N I FSECURM LILN J <br /> Address W, iONdfi A VC, 7TIH-0-4 Llcense#TC,1-3 00 G ILI 0 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I YIN I FERCURREN I Y/N <br /> Addressnoo w. i4nAml? our_ Tn'"A19 Li tsB#IF-C 13(10 <br /> PLUMBER r COMPANY <br /> SIGNATURE Y/ N FEE cuRREI, <br /> Address License# <br /> M COMPANY <br /> = <br /> SIGNATURE REGISTERED I Y/ N FEECURRE!, L)LLN J <br /> Address License# <br /> OTHER COMPANY .= <br /> SIGNATURE REGISTERED YIN I FEE CURR8A Y/N <br /> Address —1 License# <br /> is I fillisto <br /> RESIDENTIAL Attach(2)Plot Plans:(2)sets of Buliding Plans,(1)set of Energy Forms;R-O-W Permit for now construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&I dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Ure Safety Page.(1)set of Energy Forms.R-G-W Permit for now construction. <br /> Minimum ten(10)working days after submittal date. Required arisite,Construction Plans,Stornwrdtar Plans w/Silt Fence installed, <br /> Sanitary Facilities&I 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 /> Oft.1 fte i t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> It over$2500,a Notice of Commencement Is required. (AIC upgrades over$7500) <br /> Agent(for the contractor)or Power ofAtbomay(for the owner)would be someone with notarized letter from owner authortdng same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Retools if shingles $aware Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Ofiveways-Not over Counter if an public roadways-needs ROW <br />