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r """• ""' rw -o 1a- 1 6U -vvc.I <br /> Building Department <br /> Date Received 5 -6-0 ,,, `'' I �, <br /> Phone Contact for Permittin. FL-3 26? - g10.5 <br /> Owners Name I 4 U / 0'1 / r <br /> Owner Phone Number : 3 -7a . 5-8 Z-S 1 Address I 38 �� 4,,�_ I <br /> Owner Phone Number <br /> Fee Simple Titleholder Namel <br /> Owner Phone Number <br /> Fee Simple Titleholder Address I <br /> JOB ADDRESS 13h02... ? , - €. Z,eph ,e4„ <br /> Y // �C- 3 3 s y Z I LOT # <br /> . <br /> SUBDIVISION C '"l- / el . 2 e Y�e.(�,1 PARCEL ID# 1 1- 2- 6 ' " <br /> 0010 - /&.,00 pa // <br /> WORK PROPOSED (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NEW CONSTR I ADD /ALT [El SIGN <br /> INSTALL REPAIR n MOVE n DEMOLISH <br /> PROPOSED USE SFR n COMM <br /> TYPE OF CONSTRUCTION BLOCK n OTHER <br /> - Q FRAME n STEEL n OTHER <br /> DESCRIPTION OF WORK - � - � 57 4/ f � � G /) <br /> ca v . � ✓cz w / TH Cy - . i <br /> BUILDING SIZE <br /> SQ FOOTAGE HEIGHT <br /> n BUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION / 2 / 2 # (-,G6 <br /> I <br /> ELECTRICAL <br /> AMP SERVICE n PROGRESS ENERGY 0 W.R.E.C. <br /> [= PLUMBING $ <br /> ED MECHANICAL <br /> VALUATION OF MECHANICAL INSTALLATION <br /> fJ GAS Q ROOFING Q SPECIALTY r-� <br /> FINISHED FLOOR ELEVATIONS ► 1 OTHER <br /> FLOOD ZONE AREA AYES =NO <br /> BUILDER �� ' � <br /> ' <br /> SIGNATURE �� � A.,.... 6911' ! d BB <br /> C OMPANY <br /> REGISTERED �fIY r FE f• �(. <br /> Address S r� FEE CURRENT Y / N <br /> Z r PA2 CI 2 57 <br /> ELECTRICIAN olZ 4 , o G L 3 2 /9 License # .0 (500-F1 1 <br /> SIGNATURE COMPANY <br /> REGISTERED ® FEE CURRENT NM <br /> Address <br /> PLUMBER <br /> License # li====i1 <br /> SIGNATURE COMPANY <br /> REGISTERED ® FEE CURRENT SUN <br /> Address <br /> License # <br /> MECHANICAL <br /> SIGNATURE COMPANY IIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIM <br /> REGISTERED ® FEE CURRENT <br /> Address <br /> OTHER License # <br /> SIGNATURE COMPANY <br /> REGISTERED Illair■ FEE CURRENT WEE <br /> Address <br /> RESIDENTIAL License # <br /> 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 Facilities & 1 dumpster; Site Work Permit for subdivisions/large-projects <br /> COMMERCIAL <br /> . Attach (3) sets of Building Plans; (1) set of Ene nce installed, <br /> Minimum ten (10) rgY Forms <br /> R -O -W Permit 'for new construction. <br /> ( ) working days after submittal date. Required unite, Construction Plans, Stormwater Plans w/ Silt Fence Install <br /> SIGN PERMIT Attach Facilities & 1 Engineered P Site Work Permit for all new projects. AR commercial requirements must meet CO <br /> Att (2) sets of Engineered Plans. Installed, <br /> "' "PROPERTY SURVEY required for all NEW <br /> ■u■u ■+ uu■■■■■■■ uu■■■■■■■■■ u■ u■■■ u■ u■■■■■ u■■ u■ uuu ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■■ compliance <br /> Directions; construction. 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) <br /> Agent (for the contractor) or Power of Attome <br /> OVER THE COUNTER PERMITTING y (for the owner) would be someone with notarized letter from owner authorizing same <br /> Reroofs Sewers (Front of Application Only) <br /> Service Upgrad A/C <br /> Driveways -Not over Counter If on public roadways.. needs ROW Fences (Plot/Survey /Footage) <br /> • <br />