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<br />81 :3- i 80-0020
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<br />L;lty or Lepnyrnllls r-ellllll MjJjJllvdllUl1
<br />Building Department
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<br />'10 (/f
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<br />Fee Simple Titleholder Name
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<br />OWner Phone Number e /,3 - 780 - 0 () tf) 6
<br />V.llLOwner Phone Number I
<br />OWner Phone Number I
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<br />Date Recei"ed
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<br />OWner's Nama
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<br />OWner's Address
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
<br />I 39'f2/ .souT/'
<br />I
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<br />Ave Ze;Djyr~//1.r, /L
<br />I PARCEL 10#1
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<br />LOT# I
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />[8] NEW CONSTR D ADO/AL T 0
<br />D INSTALL D REPAIR
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<br />PROPOSED USE D SFR D COMM 0
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<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
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<br />DESCRIPTION OF WORK I AI> aYe <] rou h oI-f(,(.e/'/)~ I'ac;'/;",J
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<br />BUILDING SIZE I sa FOOTAGE I I HEIGHT
<br />I II I I I , , , I I III I , , I r , I P I I I I , I , I I I , . . I r 11 I I . I . . I I I II I I ~ , , I , I I' 111 II I , , I I . II I I , I I . I II . I I II , , II 111 f I II I I II , P , I III1 , I . III I , I II" I , , , II , , . r . I ,I I . I I , till I
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />DEMOLISH
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<br />OTHER I
<br />STEEL D
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<br />OTHER I
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<br />D BUILDING 1$
<br />, 3 2- 9. h LI'I. 77
<br />.
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<br />D ELECTRICAL 1$
<br />/9 S'OO. (JO
<br />.)
<br />D PLUMBING 1$
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<br />D MECHANICAL 1$
<br />9; 6cJ2,cJ()
<br />,
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<br />D GAS D ROOFING
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<br />FINISHED FLOOR ELEVATIONS I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />D
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<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D
<br />I
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<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
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<br />DNO
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<br />BUILDER
<br />SIGNATURE
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<br />
<br />
<br />Address
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<br />COMPANY IAI/ /!mer;'CCfI, COJlCI'e-f-E5 ~c...
<br />REGISTERED I IT2J N J FEE CURRENT I C'OI N I
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<br />License # I CG C 05 If /9 C;
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<br />
<br /><.~~~
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />OTHER
<br />SIGNATURE
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<br />J;ci.UJ/l v/~
<br />
<br />I
<br />
<br />
<br />License #
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<br />.......
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<br />Address
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<br />MECHANICAL
<br />SIGNATURE
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<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />License # ,. W-loc:ro8Z..7-
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT Y I N
<br />
<br />Address License #
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<br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111'1
<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 onslte, Construction Plans. Stormwater Plans wI Slit Fence Installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlslonsllarge projects
<br />COMMERCIAL 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 onsite, Construction Plans, Stormwater Plans wI Slit 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.
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<br />DI~~~ti~~~': . . , , . . , . . , . . . . . . . . . . . , , . . . . . , , . . . . . , , . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . , . . , . . . . . . . . . ~ . , . , , , . . , . , . . . . . , . . . . . . . . . , . . . . . . . . . . . . , . . , . . . . . . . . ,
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<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 $5000)
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<br />.. Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades Ale Fences (PloVSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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