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813-78U-002U „,, 13 -78U UU'1U laity 01 LGt111y1l illy f CI I I I�t nyNnvouvi i , 2 G` t / �, � Building Department 1 ( �/ Date Received Phone Contact for Permittlnt 8 / 7 b (12 3 4 3 __ Owner's Name ALNA/I1K 1/o' -leS Owner P Number X8/3) '7 9 -- 7 Owner s Address 14 Do / IliSfS/#o,C 8L1/0 1 AMVA A- 3364I Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address I � � /� I/ kip LOT # : JOB ADDRESS I37k 52� /7K/ /I YN kiD 7EPii/yie/9:/LL.� G 0 I ( S 1 / . I s SUBDIVISION PARCEL ID# ( � •�!�� 1 ��Q' 23 t 7 "`DOs�t�t' 7 `a•� (OBTAINED FROM PROPERTY TAX NOTICE) ' NEW CONSTR I ADD /ALT 1 I SIGN FT MOVE = DEMOLISH WORK PROPOSED � a f I • REPAIR INSTALL PROPOSED USE n SFR 1 I • COMM n OTHER 1 - 1 TYPE OF CONSTRUCTION 1 BLOCK 1 i FRAME • n STEEL 1 1 OTHER 1 DESCRIPTION OF WORK 1 /Y Ew CoMfreuCT On) 1 ow,V 04044.. I BUILDING SIZE I I SQ FOOTAGE I /53 / 1 HEIGHT 1 a siiCY • I Q B 1$ 3 i„ 65 I VALUATION OF TOTAL CONSTRUCTION n ELECTRICAL ($ 3 'it/0 I AMP SERVICE PROGRESS ENERGY = W.R.E.C. n PLUMBING $ 4 /t. II is ✓. n MECHANICAL $ 5(� VALUATION OF MECHANICAL INSTALLATION NC SPECIALTY n OTHER 1}j1P S6C A /a- � cYl;.� n GAS n ROOFING a oc,7 FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES =NO. 2 -' I ,/ 904 /Q COMPANY 1 LEN/VAC # 1 s I BUILDER SIGNATURE A - FEE CURRENT REGISTERED 1 Y N I D 1 Y / N 1 Address i 0A/ Al . ,. 04E BLfro - 715311,4 M, / 33409 License# 1 CSC/ el 5 ELECTRICIAN COMPANY 4 0/Y6A/ 50. 4/ 4 GE•GT /C ZA/ C SIGNATURE ` • REGISTERED • 1 Y/ N 1 FEE CURRENT 1 Y / N 1 Address (, / .03 ..SK P/?4 /s0/4P, fi. 3s6,/ 3 License # ESC ` 00 o 2S 79 PLUMBER COMPANY Bi / P.1- A 4 6 / N 6 SIGNATURE �� REGISTERED ' I Y / N 1. FEE CURRENT 1 Y / N 1 Address ( b 39.7 //'V 3o/ S ,./21 d C 2 1 / / £ � f 2 3 3 5 1 8 License :# ' Cf 7 /SO 0 MECHANICAL COMPANY 8 0A/ET v G /.t/6• j = de- $7? , 1,1 G SIGNATURE REGISTERED Y / N 1 FEE CURRENT ;' 1 Y / N 1 ; Address A 0•' So)( .530g 3oyoA/fr76,wr, FL39 ?4'I License # CAC ns$ .0 6 2 OTHER COMPANY C. ..,Crtad NG- (109i/ ? oo"uG, Svc. SIGNATURE - REGISTERED 1 Y/ N 1 FEE CURRENT' 1 Y / N 1 Address • ¥1/1 . SW AL L /0F 31-V0 SP IN !t/GG, c635/ic7 License # • 1 CG -.Ca 5-7•99 ; j RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -OM 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) 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. 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 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 ,