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Cl l.:l- (ClU-UULU lJlty oT Lepnyrnllls r'ermlt Application Building Department rax-tll j-I tlU-UUL 1 Date Received OWner Phone Number OWner Phone Number I OWner Phone Numb~r I Owner's Name Owner's Address Fee Simple Titleholder NamJ JOB ADDRESS Fee Simple Titleholder Address I Ic:s~~ ~ I \~ \\, ~\. LOT# I I PARCELlD#I\ \ ._~-~\-ttJX)-\ \~~C)\~$) I ~ (OBTAINED FROM PROPERTY TAX NOTICE) ([) \ lot) N~WCONSTR ~ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH . INSTALL t=I REPAIR PROPOSED USE 0 SFR D COMM 0 OTHER TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL 0 DESCRIPTIONOFWORK l\a~~~\C"$ ..~l~~",*- C)~.' \~'l\~~~ . . , BUILDING SIZE I I SQ FOOTAGE I ~l\L Cl I HEIGHT I . I L.1I . I . . . I . . . I . I . . I I I . . . . . I . . . I I I . I . . . . l . . . . . . I . ~ . I . . I . . . . I I I . I I I . . . . . I . . . . I I . . I . . . . . . . . . . . . . I . . I I . I . I . . . I I I I I I . I I . . . I . . I . . I I I I I . I . . . I I I I I I Q7 BUILDING I$c:v 0\.i)~., \(;) . VALUATION OF TOTAL CONSTRUCTION i . D ELECTRICAL 1$ AMP SERVICE D PROGRESS ENERGY D PLUMBING 1$ D MECHANICAL 1$ D GAS D FINISHED FLOOR ELEVATIONS I SUBDIVISION WORK PROPOSED OTHER I D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION ROOFING D I SPECIALTY 0 FLOOD ZONE AREA OTHER DYES DNO BUILDER COMPANY SIGNATURE' ~~ ) REGISTERED A~~' LC\C)).~::> D\CJ(t 6'6 \'S3'Q. (J ..1 ELECTRICIAN COMPANY SIGNATURE . REGISTERED License # ~?-)t CY5\\~~ I-=\\- c.v~ I YI N FEE CURRENT License # YI N FEE CURRENT License # Y/N FEE CURRENT License # Y I N FEE CURRENT License # Y/N Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N Address COMPANY REGISTERED MECHANICAL SIGNATURE Y/N Address OTHER SIGNATURE COMPANY REGISTERED Y/N Address "I"" I I1I11II 1111111111111'" 1111111111111111111111111' 1'1111111111111111111111111"111111111111111111111111' II" 11'1111111111111' 11'11'1" I" , RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onslte, Construction Plans. Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of BUilding Plans; (1) lIet of Energy Forms. Minimum ten (10) working days after submittal date. Required onslte. Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY.SURVEY required for all NEW construction. I I l I I I I I . I I I ~ l I I I I I I 1 1 , 1 1 1 I . I I I I 1 1 I I I I I I I I III I I I I I J I 1 . I 'I I I 1 I I I 1 1 I I . I 1 I 1 I . I I I I I I I I I 1 I 1 I I I I 1 I I I I I I I 1 1 1 I I I I I I I I I I I I l I & I I & & I I I & i I I I I I I ~ Ii. I i I I I I I I I I I i Directions: Fill out application completely. Owner & Contractor sign back of application. notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Driveways Fences (Plol/Survey/Footage)