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813- 78U -UU2U LILY Ul Lpliyiiiiii b r'ciiinn. nJNiwauvi1 Building Department Date Received Phone Contact for Permlttin e 8 / ‘11.4 3 4 3 Owner's Name ' A EN . WM #0, Owner Phone Number (10 l i ' ' /1 0 ' 33w v Owners Address / Lati "t* i�E A "' 1 /d Ci64 .1A L , Owner Phone Number 1 Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 376 B 2 gA 4L A/ 760X/ye.hita i 33 0 LOT # 1 5-9 i SUBDIVISION. 6 /4-4ND . �/QIt.JL- PARCEL ID# 0.3 6 X21 0.23o- 0000o - e, '590 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED ► �� NEW CONSTR I i ADD /ALT , 1 SIGN n MOVE. n DEMOLISH O INSTALL REPAIR PROPOSED USE = SFR ( I COMM n OTHER I TYPE OF CONSTRUCTION BLOCK 1 1 FRAME n STEEL n OTHER DESCRIPTION OF WORK ' A/EAt/ COAACP2UC> OA) " - TOWN /40A40s BUILDING SIZE SQ FOOTAGE / 3 7 / HEIGHT a Jiv y B $ 3 // 45"o VALUATION OF TOTAL CONSTRUCTION n ELECTRICAL $ 3 y yo AMP SERVICE If,W1 PROGRESS ENERGY n W.R.E,C El PLUMBING $ 14.3.7.7 n MECHANICAL $ 1 /.2 510 VALUATION OF MECHANICAL INSTALLATION n GAS n ROOFING 1 1 SPECIALTY n OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES rTNO ' / BUILDER COMPANY AW --. NO ''1 SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N Address ' • ' /v .4✓a • •• &N0 149, ,4 33409 License # CSC,/ +? 55 ELECTRICIAN COMPANY 40/Yo,u 5041 EL +EC'f /G. ZA/ C , SIGNATURE � REGISTERED ' 1 Y/ N 1 ' FEE CURRENT 1 Y/ N 1 Address , / 0,3 .SK/ ' ' . ' /a0/' p fL 33613 3. License # I eC 00 O ass 79 PLUMBER 7/ COMPANY FA An/ PL M /$ iNG SIGNATURE 2 REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N Address 637.7 /J S /. ,. ,€i veg. v/£ ,cL 3357S Ucense.# CPC /,S 0 MECHANICAL COMPANY 8.4yOn/,rg ?d /.f/crr 6,9 'vG'/ ' SIGNATURE i REGISTERED Y / N 1 FEE CURRENT ; , ' 1 Y / N ' Address /� 0. BO)( 3�yoNET PoiNr P!....36?(/1 License # CAC a sg 06 2 " OTHER COMPANY C. �S'rAti- /�t/ rc uG vc SIGNATURE ! , REGISTERED I Y / N I FEE CURRENT " 1 Y / N Address 1 5/7044 L/ j f 8LV0 sPadiv *14 FL3y‘0 License # - GC- - Co S? 99' 1 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 onslte, Construction Plans, Stormwater Plans w/ Sllt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /.large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Ufe Safety Page; (1) set of Energy Forms: R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans wI Silt Fence installed, Sanitary Facilities & 1 dumprter. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT . Attach (2) sets of Engineered Plans. " " SURVEY required for all NEW construction. lillllllllll11)H1H 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 Powet 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