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<br />Date Received
<br />
<br />
<br />Building uepartmem
<br />
<br />p2 1,~5/3
<br />70'(;( ,<f;q
<br />t6' 7')'1'-/
<br />Owner Phone Numberf 8/3) g-gS -'7'7+'1
<br />Owner Phone Number (8'J3) 8g>5~ 7?L/-t(
<br />
<br />Owner's Name (). +tOV I it )
<br />I '?fj , T~ fL
<br />Owner's Address 6Lf i1a:J:>>r>rdCiJJiJbn CiR (em 3...~3 ~
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />~~Q~~/~ .. I LOTN
<br />
<br />. ve. ,'0 PovQ)~, PARCEL ID#lo-f-bKP-al-WoO "EXi?iYJ-OI50
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D SIGN 0 MOVE D
<br />
<br />D
<br />D
<br />
<br />1/6/3
<br />
<br />.
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />~
<br />~
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />B
<br />D
<br />D
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOliSH
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />[29
<br />
<br />OTHER
<br />
<br />DESCRIPTION OF WORK
<br />
<br />
<br />HEIGHT I
<br />
<br />BUILDING SIZE
<br />
<br />1111,..11,..11,..1111.,.....1,..11,..,11.'.,..1,...1111.11...1....11,..11."..111,...11...11,...,11.....1111......11111.1.."".1""1111,..,.,..,111
<br />
<br />D BUILDING 1$
<br />D ELECTRICAL 1$
<br />,~ PLUMBING 1$
<br />D MECHANICAL 1$
<br />D GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />Cleo,
<br />
<br />.-
<br />
<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />ROOFING
<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
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<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED YI N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED I Y/N FEE CURRENT Y/N
<br />
<br />Address;
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address.
<br />
<br />License #
<br />
<br />{flflPJ~{o ~I ~1L-L'~jW
<br />I f N FEE CURRENT IN,
<br />
<br />License # I (1)'fLf / d---
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Addre,' SS. i/1oD6
<br />
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Addressi I
<br />
<br />OTHER I
<br />SIGNA lURE
<br />
<br />Address; I License #
<br />
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />Attach (3) 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 wI Silt 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 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
<br />
<br />YI 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Fences (PloUSurvey/Footage)
<br />
<br />Drivewalfs-Not over Counter if on public roadways..needs ROW
<br />
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