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Building Department , <br /> P i� II <br /> ate Received Phone Contact for Permittin p� . ) �(If� -- <6� <br /> —aura—A-ll�—A— —— <br /> wner's Name "a ulk� �` v nl c LU Id1 )f:C.11 c. ( L G Owner Phone Number <br /> wn�r'sAddress 21t�%2 ,.�41keil�jttt blk�(,r� L <br /> J Owner Phone Number <br /> w Simple Titleholder Name / Owner.Phone Number <br /> :e Simple Titleholder Address !A <br /> JB ADDRESS `Z (loch ilk vi ` LOT# <br /> UBDIVISION �a.l�s M I[?. PARCEL ID# ® L�J�® <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> FORK PROPOSED NEW CONSTR 8 ADD/ALT SIGN Q DEMOLISH . <br /> INSTALL REPAIR <br /> ROPOSED USE 0 SFR 0 COMM OTHER <br /> YPE OF CONSTRUCTION ] ``BLOCK (Q FRAME STEEL ' Q <br /> ESCRIPTION OF WORK <br /> l <br /> _ . .// <br /> ,U.ILDING SIZE 3 SQ FOOTAGE ��"�-'� 1• HEIGHT � / <br /> BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> J'qJp; <br /> 1; � b <br /> =ELECTRICAL $ 9''f!,D O AMP SERVICE PROGRESS ENERGY = W.R.E.C. <br /> -/ lI GLI,t,-VZ (FhaGtL <br /> =PLUMBING is <br /> J <br /> =MECHANICAL Is �/ 6'�OG VALUATION OF MECHANICAL INSTALLATION <br /> `'/ oC <br /> =GAS Q ROOFING = SPECIALTY = OTHER <br /> °INISHED FLOOR ELEVATIONS /j� r FLOOD ZONE AREA =YES NO <br /> ``���� <br /> - -- - - - - - -- - - - - - - <br /> 3UILDER. COMPANY c'-lfe dvm(-. (/- I)Nodw L�L <br /> NGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address (p�ir�5: l nl r�: /�l[�� L�3 -. License# <br /> ELECTRICIAN COMPANY �UG r lG <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address Ar - License# <br /> PLUMBER COMPANY �r' r � I °�✓"� l <br /> SIGNATURE ,I E4-REGISTERED Y 1 N FEE CURREN <br /> Address 3132, t ?�-7 �"I�GJrld 1::01F1 7 * LLicense# <br /> 4 <br /> MECHANICAL ` COMPANY flW I S""f;r(Odl I,{&!/1Cf� <br /> SIGNATURE REGISTERED Y/ N. FEE CURREN Y/N <br /> R/3/7Grl.Address f w, dSZ�1,FL 3 c/(4a-7 License# % 3 20 <br /> � / <br /> OTHER" COMPANY 1 q"/` r"`/��/ <br /> SIGNATURE" REGISTERED Y/ N FEE CURREN Y/,N <br /> Address:. �191:��/n Q�) ") i3 . License# <br /> a'aaa99"A ➢ Aa BID.69a9d .aagaaa1 ➢ a0AAaaa0gaaaaa0a ➢ IIa0911 ➢ 9a9aa ➢ 109aaa9 :0 .a-99a <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 wl 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 Fonns.R-O-W Permit for new.construction.: <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater:Plans wl 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 />