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<br />Date Received
<br />
<br />
<br />'-'.,] VI ...."'t'..J......-. -........ .,..,......-----.-
<br />Building Department
<br />
<br />Owner's Name
<br />
<br />\
<br />Owner Phone Number I ~ \ 3 - c ~ <i?'1 - i.{ ~ It L,
<br />Owner Phone Number I
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I 53 a..O
<br />1---
<br />a
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK It., 10. r ~ s < ~,,\ J:S-7n. \ \p. -\-.. "" n.. "J, (l ~~ I r · -i:" '1;.-.:.< il
<br />
<br />BUILDING SIZE I sa FOOTAGE L I HEIGHT I
<br />
<br />JOB ADDRESS
<br />
<br />3r-d.
<br />
<br />s+
<br />
<br />Ze.~""1 r- '" ~ \ \~ I F l
<br />I PARCEL ID# -
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />
<br />
<br />33~ t.\ ::L
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />
<br />B
<br />D
<br />
<br />(OBTAINED FROM PROPERTY TAX NOnCE)
<br />SIGN D MOVE D
<br />
<br />WORK PROPOSED
<br />
<br />D
<br />~
<br />
<br />~~;:~ ~~~O~~~ER ~\~P~~e :;0 \
<br />
<br />1111111"""""""'11111111111111111""'1111111111.",'111111111111111"""""""'1111111111111"""""'."111111111111111111111111111111
<br />
<br />1$ ~ Cf,tJcJU
<br />
<br />1$
<br />
<br />1$
<br />
<br />1$
<br />
<br />c=J GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />c=J
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />c=J
<br />c=J
<br />c=J
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />?ou)eA R6<E~
<br />
<br />W.R.E.C.
<br />
<br />PLUMBING
<br />
<br />(!) /cIFCJJ
<br />FD,Il.m
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />NDL- /
<br />
<br />MECHANICAL
<br />
<br />ROOFING
<br />
<br />D
<br />I
<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />~c ~
<br />
<br />Ikf~~OO\EE~~E~ ~~,PN t~C
<br />
<br />P; 3358'-1 License # Ie:. PC' \ 1..\ S l. lL d... ~
<br />COMPANY I
<br />REGISTERED
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMMERCIAL
<br />
<br />Address
<br />
<br />
<br />MECHANICAL I
<br />SIGNATURE ,
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />~~I ~~#
<br />
<br />I1111II111111I1111111I111111III1111I11111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<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 onsile, Construction Plans, Stormwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslonsllarge projects
<br />Attach (3) 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 onslte, Construction Plans, Stormwater Plans w/ Slit Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />Attach (2) sets of Engineered Plans.
<br />...-PROPERTY SURVEY required for all NEW construction.
<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 />SIGN PERMIT
<br />
<br />Di~~~ii~~~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 . 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 .
<br />
<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 Attorney (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 NC
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<br />Fences (Plot/Survey/Footage)
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