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<br />bl,j-/bU-UU-'U <br /> <br />L;lty of Lepnyrnllls I-"ermlt AppliCatiOn <br />Building Department <br /> <br />rax-b16-/bU-UULl <br /> <br />Date Received <br /> <br /> <br /> <br />JOB ADDRESS <br /> <br />I <br />I <br /> <br /> <br />Fee Simple Titleholder Address I I <br /> <br />1'2=>\\.D(;)~L\\1(~~~~22) ] LOT # 16):),1 <br />t~<;:\ \-\D"\(~-I .PARCELID#I~~-(J\~(')~"Q~S/I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />ff 0 SIGN D MOVE 0 <br /> <br />D 0 <br />D 0 <br />",,' <br />-\ <br /> <br />,))\-\(:) . <br />Owner's Address 1"llli-\5 \ '-~ ~'(~V ' U{ <br />Fee Simple Titleholder Nam~ <br /> <br />Owner's Name <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />r-q.-/, '.rN --- EW CONSTR <br />~ INSTALL <br />D SFR <br />D BLOCK <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br /> <br />~ <br />I <br /> <br />BUILDING SIZE I I SQ FOOTAGE D~ HEIGHT I ,I <br /> <br />~-,-(.......................................................:............................................................ ............... <br /> <br />BUILDING 1$ 0':\ \ S:>l~~ _~~ VALUATION OF TOTAL CONSTRUCTION <br /> <br />~CTRICAL 1$ , I AMP SERVICE D PROGRESS ENERGY D WRE,C, <br />" ~\(\(~~~\ <br />D PLUMBING 1$ I .~~~::43~ <br /> <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION - fJli0 ~ <br /> <br />o GAS 0 ROOFING D SPECIALTY 0 OTHER j 2- O. ~, ' <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 0-~blh1f..tt <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />Address, ! <br />PLUMBER <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />~M~~NY1~,~-.&~~\~ <br />REGISTERED l~ i FEE CURRENT 1 \ Y I N T <br />, ... ~ ~\..c License # ~ \.""")"\ \ ~~ I <br />C~M~ANY I C\~~ ~~\i';L I <br />REGISTERED ~ r Y t N I FEE CURRENT I Y I N <br /> <br />~~~~ License # I \~ I <br />I COMPANY I I <br />REGISTERED Y I N FEE CURRENT Y I N <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />RESIDENTIAL <br /> <br />'1111"'tllllllllll""111111I'III"'III11111111111'1111111'11111111111111111111"1111111"1111""11'111111111111""1111111"111"11111'11111111 <br /> <br />License # <br /> <br />COMMERCIAL <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans. Sanitary Facilities & 1 dumpster <br />. Attach (3) sets of Building Plans; (1) !;let of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans. Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVI::Y required for all NEW construction. <br /> <br />SIGN PERMIT <br /> <br />H ~ .. 1111. I 11111. . III ~ ~ I III ~ IH 11111 H . III . . I II III . II U . II "HI U I H . III II .. III . 1111111 ~ .. 111111111111111111111111 j I ~ 1111. J i 1IIII1 I , i , Ii IIIII II II ~ <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. (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Driveways Fences (PloUSurvey/Footage) <br />