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<br />\..IllY VI L.C:;pIlYIIIIII~ I \,JIIIII\' 't""t""II--"'---
<br />Building DepartmefJA
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<br />phane can..:t!a12"tln. g 13 ,9/3 -
<br />Owner Phone Number ~ /3 ~ 1 g3~ 3L{1
<br />Owner Phone Number I
<br />Owner Phone Number I
<br />
<br />tS'l j-{ tlU-UULU
<br />
<br />
<br />... ~- 0
<br />He f1: J J5 LJ.,C
<br />Owner's Address l~qqJ E. ComeJbacL Rei ~f1sd(}-lc #\2- tlSZ5/ I
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<br />Fee Simple Titleholder Namel I
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<br />Date Received
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<br />Owner's Name
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<br />Fee Simple Titleholder Address I
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<br />I 3251 [que) '!tll~ Rd I
<br />I Mo.jt~ -ft'~ OOv/c.s I PARCEL 10#\24 - Z(p- 2/-0600 -00/00-
<br />~ L.~ vo.J ley 81 vtI (OBTAINED FROM PROPERTY TAX NOTICE)
<br />0/ NEW CONSTR r=J ADD/AL T D SIGN D MOVE D DEMOLISH
<br />W INSTALL D REPAIR .----/
<br />PROPOSED USE 0 SFR D COMM L.J:1 OTHER I
<br />O BLOCK r-I FRAME 0 STEEL r:-7'i
<br />TYPE OF CONSTRUCTION L-J LYJ
<br />
<br />
<br />;~~;~~;~~;~~~j!!, ~ ,~~~" ~f~,~~ ~,~;~;C~, : ~ , " " " " "I" " ,~~I~~~ ,! "." " , " " , " , " , " ,I" , ' " , " " , " , " " " , ~
<br />
<br />D BUILDING 1$ /5000. oc
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<br />D ELECTRICAL 1$ 200.00
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<br />D PLUMBING 1$ J()O." 0
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<br />D MECHANICAL 1$ 600:0
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<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES G1No
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<br />
<br />III 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 II I I I , I I , , , I II I I " : II I II I I I , .. I .. I II I , , I ., I ., I I , I " I I I 11 I I , I I I , I I I , I I I I I I 1 I I II I I I I I I I , I I I ~ I I I , , I , , I I I
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />LOT# 130
<br />cdI{)
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<br />OTHER I pw).-M{)o.4
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<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
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<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />D
<br />
<br />WR.E.C
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
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<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />I ~~~~~~eJ1EE~!i~ I Y/N I
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<br />License # 1/ /-1 C>{)cJ(jO~O
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<br />I Vandd/ r/~(;fF1'v
<br />I Y / N I FEE CURRENT I Y / N I
<br />License # IE ROOI 'l- 9/ D,
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<br />rv~;;r~-~~UR~~~-IS I Y/N I
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<br />License # II 1-1 Oca:x:J ~ 0
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<br />1~0r5
<br />I Y / N I
<br />
<br />FEE CURRENT I Y / N I
<br />
<br />License # I CAe 0 Lf39 'I ~
<br />
<br />Y / N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Address License #
<br />
<br />111111111111111 I 11111111111 J I111111111 J 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 J 11111111
<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 w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 Silt 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.
<br />11.1111! 1111111111111111111111111111111111111111111111111111111111111111111111111111111 1111111111111111111111111111111111111 i 11111111111111 11II1111
<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)
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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 AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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