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Date �p� q 1- s Received Received Re.d 1 1 Prone Contact for Permitting V b l n L lS !ill - 1 t , 1 <br /> Owner's Name I N 1 Ft-- 11 ; � <br /> 7 LC 1 Owr Phone Number I N, 1 - (� 3.1 ` c I$ i <br /> -^^ owners Address IVrr ..; s ._►i1 -_ �l N. ��`.si_•_ Owner Phase Number 1 <br /> Fee Simple Titleholder Martel N A Owner Phone Number 1 <br /> Fee Simple Titleholder Address IN h <br /> JOB ADDRESS d ? J T� (p— �` X 17.1 C F(' i R.1 e 3 , /�' ee tr LOT* gyp 1 <DID <br /> SUBDIVISION s d 3k <br /> ( «f() <br /> - •2 t-( /v� 1.711c'�[ I LIQ <br /> J (OBTAINED FROM PROPERTY TAX NOME) <br /> WORK PROPOSED NEW CONSTR ' ( ADDIALT I SIGN (fl MOVE E( DEMOLISH <br /> INSTALL (� REPAIR <br /> PROPOSED USE 1l SFR n COMM Q OTHER 1 <br /> TYPE OF CONSTRUCTION E1 BLOCK r i FRAME [J STEEL OTHER I i' I <br /> DESCRIPTION OF WORK & rnt xi C-T ) LJ-p ( rep )1 cemo nt) <br /> BUILDING SIZE I t x I SQ FOOTAGE 1 y r HEIGHT I 1 <br /> ■ <br /> I 1 BUILDING I$ cly ,� A ' 00 I VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ ( � O I AMP SERVICE n PROGRESS ENERGY fI W.R.E.C. <br /> El PLUMBING $ <br /> Fi MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br /> ID GAS 1' ROOFING n SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IVES 1 <br /> a . _ .. ...... ... ........ ... .... ......... <br /> BUILDER <br /> GNATURE ' / • 4F REG ISTERED �� ���`� �� 1 ._ <br /> ( � N ( FEE CURRENT Y / N <br /> Address * i I ti4 , d. it .' . _11 & AMP 22053 License t # 1 aAL0 I <br /> ELECTRICIAN 9 ' COMPANY 11&l1 ` A e RRE .n I <br /> SIGNATURE L ^'Q ,� REGISTERED 2 `j)a� F l FEE woman' Y / N <br /> Address ;Ng 41376.../ 35 b7 i s Mier1 El 7.A.. rh; IIS11 33540 Lice 1 J <br /> SLUMBER C fJGai�/ D A /7 l COMPANY N 1 1 CURL N 't I ¥ / N S� SIGNATURE I�.�/� REGISTERED ( / N l FEE cuaREn 1� � ( T Y / N ^ ( ` <br /> Address u' k , •_ A I I' 2 I I ,/1 f _ 3 53 License # 1 tT1- b1h3 -1 p 1 <br /> • MECHANICA I ! COMPANY 1� 5 Pr R YS, <br /> it k, <br /> SIGNATURE / REGISTERED N ( FEE CURREPIT I Y / N I <br /> Address I- I t ( , � !t _ • L. r hi ! Ft ( „ A ► Ci I License # 1 ` P L it 1 <br /> OTHER COMPANY 1 - <br /> SIGNATURE REGISTERED I li/ N I FEE CURRENT I Y / N I <br /> Address 1 1 License* <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) waking days after submittal date. Required onsite, Consbudlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dunpster, Site Work Permit for subdivisions4arge projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum tan (10) workng days after submittal date. Required caste, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary FBcltfes & 1 dunpeler. Site Work Permit for all new projects. AM commercial requirements must meet compliance <br /> SIGN PERMIT Mach (2) sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <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. (A/C upgrades over $5000) <br /> •• Agent (tor the contractor) or Power of Attorney (fa the owner) would be someone with notarized latter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage) <br /> Driveways -Not over Counter if on public roadways-needs ROW <br />