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Fee Simple Titleholder Name \..IllY VI Lv}JI 1]1 I 1111";' I '-'11111" I 'fJt-'II--"'-" Building Department tl"l j- (VV-vv.<:v Date Received Owner's Name Owner's Address JOB ADDRESS Fee Simple Titleholder Address I IJ4'fl AqlAaman/J~ ILme/a ld Poil)1e- I WORK PROPOSED NEW CONSTR INSTAll SFR BLOCK W Qj . I LOT # I 2 / PARCELlD#12L{-2Cp-2!- {)6 20 -00666" 6Z{C> (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE 0 SUBDIVISION PROPOSED USE TYPE OF CONSTRUCTION B D D DESCRIPTION OF WORK l~_lJ\I'od. e... \ S e... -t ~ BUilDING SIZE I /L{ 1-3 Z SQ FOOTAGE ILf'-f ~ 11111111111111"1111111111111'"111111111111111111111111111,111.111..1111111.....'.....1111111..111111......"11111111111111'111"111111111111111'"1 ~ o o ADD/Al T REPAIR COMM FRAME o o o DEMOLISH OTHER I 'Pa/ J:-Mod L I STEEL D OTHER If'I1d:J/1L HEIGHT I D BUILDING 1$ ('2>0.00 I VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ 2S0. Ot> I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. D PLUMBING 1$ 2- 00 . 00 I D MECHANICAL 1$ '5"00.0-' I VALUATION OF MECHANICAL INSTALLATION D GAS 0 ROOFING D SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO I I I I , , I I I , I I , , I I I I I I , f , I I I , , I I I I I I I I I I I I I I I ~ r 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 , 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 If' , I I I I , BUilDER SIGNATURE PLUMBER SIGNATURE COMPANY REGISTERED IBi~~~~UR~~5 IO/N I License # II HO O()6 ~ ~ 0 Ell-cffi~ I Y / N I License # Ie ROo/29/0 IB~~f~f~~C~E~j I Y/N I License # IIH..10000cP<:J 1/3a.hrJ pr7;)~r)f2 a.4 A / C I Y / N I FEE CURRENT I Y / N I License # I G4 c (:) </3 '1 (j;g CrarJd a.J I I Y / N I FEE CURRENT COMPANY REGISTERED Address MECHANICAL SIGNATURE Address OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111 J 11111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTy SURVEY required for all NEW construction. 111111111111111111111I1111111111111111111111111111111 " I " 111111 " 1111111 " 1111111111I11111111111111111 " I11I1 " II " 1111 " I i It 11111111111 111111111 Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A1C upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW