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813- /t3U-UUZU t...,ity UI L.t11Jl lyl111110 1 co 11111 r.rrn.,....,.... Building Department Date. Received j - 4 - U , Phone Contact for Permittln. -- ( 1 \ Owner Phone Number .7. iv 53 Owner's Name I� u • -K. _,A L � °nt,1tis� I 0 Owner's Address w ngr Phone Number Fee Simple Titleholder Name Owner Phone Number I . I Fee Simple Titleholder Address /I JOB ADDRESS 5g 11 * �� z I Yl i/ 33 5 1 f LOT # IcI SUBDIVISION PARCEL ID# 1 t‘.-26 — �l ^ C r I . 7 - 0 0 3 0 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT SIGN 1 1 MOVE i I DEMOLISH INSTALL REPAIR W - PROPOSED USE I I SFR I I COMM I I OTHER I I TYPE OF CONSTRUCTION I I BLOCK I 1 FRAME 1 1 STEEL I i OTHER I DESCRIPTION OF WORK R%Q —POOP 40 t cs42 03141 WS/ BUILDING SIZE SQ FOOTAGE at HEIGHT I I BUILDING $ ` �/ 2 /' 17 0.00 VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ (� AMP SERVICE 1 1 PROGRESS ENERGY I _ I W.R.E.C. I I PLUMBING $ 1 : r ` I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION GAS CZ ROOFING 1 j SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES 1 , 1NO BUILDER COMPANY Y / N I SIGNATURE REGISTERED i Y / N I FEE CURRENT 1 Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE • REGISTERED I Y / N I FEE CURRENT I Y / N Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y / N 1 Address ! License # _ O - - COMPANY "gat 1 ' l' T� °'� t , I�� LP . � REGISTERED I / N F EE CU RRENT ' I Y / N I Address 10 ?� S/ 1 ' i i`1 i i(S 7 N "(! License # 1 CCCf 2-3 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 subdivisions /large 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. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) ** Agent (for the contractor) or Power of Attomey (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