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Building Department <br /> Date Received Phone Contact for Permitting <br /> EMI � r .22caa <br /> Y n �" �d Owner Phone Number <br /> Owner's Name . r FG• (. . �/ L• �� <br /> Owner's Address , (r% rr./7j I' '� f Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address WMA <br /> JOB ADDRESS ,�r ��G,i� ) (�, .. ' -) 1i '� "/ LOT# . O3o <br /> SUBDIVISION r'/f/, f. (/ PARCEL ID# 6 _6�1 40P cV -o'PO—v0®w V 3vv <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR R ADD/ALT 0 SIGN 0 Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR 0 COMM OTHER <br /> TYPE OF CONSTRUCTION. BLOCK 0 FRAME STEEL <br /> DESCRIPTION OF WORK S JtZ �l /ZZ,1/0 1rrl <br /> BUILDING SIZE f'/ �l'D/ SQ FOOTAGE pZ3% HEIGHT <br /> 'IK-1Z 7L IL 5L W CIE I Ec.AL q.M CEQ LL IL dL BE-E, k. 5E kart 3 <br /> BUILDING $ 11 q VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL Is 5 i%q , 190 AMP SERVICE 0 PROGRESS ENERGY Q; W.R.E.C. <br /> =PLUMBING $ 6 i i 7,0 <br /> 0 <br /> =MECHANICAL $ //�� Of� VALUATION OF MECHANICAL INSTALLATION <br /> =GAS 0 ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS /,�n `9),71 FLOOD ZONE AREA DYES NO <br /> BUILDER COMPANY +i <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 LZIN__j FEE CURREN Y/N <br /> Address �) License# <br /> OTHER COMPANY <br /> SIGNATURE AREGISTERED Y/N FEE CURREN �Y/N � <br /> Address rj I V�� License# <br /> @Rag@:.gag@II1.9a aug`IE OttfaNil0% a-a itEi f3 fi ld6t tt3 00 ttizeggagfRI_@ oal <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 />