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813- 78U -UU2U Lilly 01 LCpIIylI IIII rvwIn. r- pNnvau i'' • /�� Building Department l fo 51 Date Received Phone Contact for Permittln e . 1 .11,d 03 4 _ • Owner's Name • 4&/V/1/ /9X T7 O,4 • . ' Owner Phone Number $/3) ?t " 7 7 Owner's Address 4 aO /V Wt :srswOi 4 SLf/O TAArigo A-136:39 Owner Phone Number • Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address r� /� /J /J ' / t / p illy/ JOB ADDRESS a 7 ' 5c 4 n g /il Y/V ? 4#L 7EPi €41 /t &f, �L .33.5 0 , LOT # SUBDIVISION • • F / L //M C) . / . PARCEL ID# 0 - 21" 023 0.. 00000'" 69 p (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED ' ..":4 NEW CONSTR I 1 ADD /ALT n SIGN n MOVE n DEMOLISH . • Mil INSTALL I REPAIR PROPOSED USE . n SFR 1 I • COMM n OTHER I - . - TYPE OF CONSTRUCTION BLOCK ( I FRAME ] I STEEL 1 OTHER 1 DESCRIPTION OF WORK A Ew CONST'e'UGT O&) 12 wN A •S BUILDING SIZE SQ FOOTAGE /53 / HEIGHT a 5roe'g , n B $ 3 1 6 s0 VALUATION OF TOTAL CONSTRUCTION n ELECTRICAL $ g i104 AMP SERVICE PROGRESS ENERGY Q . W.R.E.C, • fl PLUMBING $ V.325- /U06 nI MECHANICAL $ 41 .2 v� VALUATION OF MECHANICAL iNSTALLATION S : a 6S . n GAS n ROOFING ] I SPECIALTY I i OTHER t 6 FINISHED FLOOR ELEVATIONS 90 / O FLOOD ZONE AREA I I YES 1 'NO. °D 0 p/s,,i BUILDER P COMPANY LEMMA/4- WO✓!. SIGNATURE /' REGISTERED 1 Y / N 1 FEE CURRENT ' Y / N Address ((POaA/ :f•/ 'c€( &fa 1i A, / 3 3GOQ License# • C8G /A Z 5 T.5/ • COMPANY 440 /o,U ,cAi �c C ICIL .ZA/ C ELECTRICIAN / SIGNATURE REGISTERED '1 Y N I • FEE CURRENT 1 ° Y / N Address , / a3y .57L/P /e-19 336/ License# tC 00 o. PLUMBER • . COMPANY BMW Ph- U M/ 3 /n SIGNATURE REGISTERED ( Y / N I FEE CURRENT ' . I Y / N I • Address & 32 //w O/ 1 .j21 : ve4s//4- ,GL 33578 License# ' , Cf 0 MECHANICAL COMPANY 8 rg M O/✓EO/i/6-;: •f,/E /17 / 0 /¢C- SIGNATURE REGISTERED Y/ N I FEE CURRENT I Y/ N • Address i A 0.•130)1 .• 8»K �� og 3, ,yoNFr/tkNr, PL.35 License ;# G osS 0 6 2 OTHER . COMPANY C. NS' TEKLy�(1(r , d 9C11"y Roo& • SIGNATURE . REGISTERED I Y/ N I FEE CURRENT" I Y / N 1 • Address ( //. 5#o4 L /uF &—v, SP2w6 /f /[L, `63si o f License # - f ' CO 3 799 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 dumps(er; Site Work Permit for subdivisions/large protects • 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, • 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. 1111111IHIIHii 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 • •