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o 1.)-' uv-UULU \,JILl VI .......t. 1_' .....' .." ~ -I' .-. Date Received . e...... Owner's Name /Z/CHIMD Owner's Address I 5 q (0 Fee Simple Titleholder NamJ ~Qt> OYCYL (7771 57 bu,Jing Department OWner phone Number 2cP1f}ft II ICC5rt?- J~ )ZI?ewner phone Number I I Owner phone Nu~b~r I DESCRIPTION OF WORK lil w ~ 1'$ 17 P1. . 9r aPt! flt-Hlle5,. ft. 335 V '"L I PARCEL ID#I tI u 2/ 0 Oft) CJ<(ffOO ()'ZVO (OBTAINED FROM PROPERTY TAX NOnCE) r=J' ADD/ALT D SIGN D MOVE D CJ REPAIR o COMM 0 D' FRAME D 5 /It' fU..- 7, z6 tfc,(~;q-, SQ 'FOOTAGE I LOT t# I I I IW"2-( ~ I JOB ADDRESS Fee Simple Titleholder Address I IS~(D I SUBDIVISION WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK DEMOLIsH PROPOSED USE TYPE OF CONSTRUCTION OTHER I STEEL D OTHER 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 . ~ . . . . '.1 . 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 W (ALJO<-v'-5 HEIGHT I BUILDING SIZE ~ BUILDING 1$ 3L/"'b~oD D ELECTRICAL 1$ D PLUMBING 1$ D MECHANICAL 1$ D GAS D ROOFING FINISHED FLOOR ELEVATIONS I I I I I D I AMP SERVICE t=J PROGRESS ENERGY o W.R.E.C. VALUATION OF TOTAL CONSTRUCTION VALUATION OF MECHANICAL INSTALLATION SPECIALTY D FLOOD ZONE AREA OTHER DYES DNO Address 4/-ee b I ~/JN L'cAff/t(/m~ I'/Vc, I YI N I FEECURRENT I' Y/N I License # I CI3c...05~ 06'7 BUILDER SIGNATURE ELECTRICIAN SIGNATURE COMPANY REGISTERED Y/ N FEE CURRENT License # Y/N FEE CURRENT License # Y/N FEE CURRENT License # Y/ N FEE CURRENT License # Y/N Address COMPANY REGISTERED I COMPANY REGISTERED I COMPANY REGISTERED PLUMBER SIGNATURE Y/N Address MECHANICAL SIGNATURE Y/N Address OTHER SIGNATURE Y/N Address II1I ' , 111111' , , , , ' 111I , II , I111I , 11111 , , 1111111111111111 , 1/111111111111111111111111111111111111111111111111111111111111 , I , 111/1111111 , 11111 , 111I111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy FORnS 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 FORns. Minimum ten (10) workIng days after submittal date. Required onslle, Construction Plans, Sanllary Facilllles & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for ali NEW construction. . 11111111111111111111111111111 . III , 111/111111111111 , , , 1/'11111 , j 1111/111111111111111111111 i i i 11111 i II i 1111 i I i II1I1 i I i 1111 i III i i III i I i III i i i i III i II i i Directions: Fill Qut appllcallon 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 leHer from owner authorizing same OVER THE COUNTER PERMITTING (Front of Appllcallon Only) Reroofs Sewers Service Upgrades AlC Driveways Fences (Plot/Survey/Footage)