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- Building Department • Date Received Phone Contact for Permittin . ±' 3 7 oot - _ � Owner's Name 41 110 , 0, • e Owner Phone Number ♦ -- S S 4 (� Owner's Address I S9 3 6 6 V►Vt bar . 5 2 7 3 5ciA Owner Phone Number Fee Simple Titleholder Name Owner Phone Number I , Fee Simple Titleholder Address I JOB ADDRESS 1 5 c) -Q--,writ I R41.4 SUBDIVISION I PARCEL ID# I 0 ia'b --a k 3o ` () sc.c) - c: \. 4 J (OBTAINED FROM PROPERTY TAX NOTICE) • WORK PROPOSED I NEW CONSTR INSTALL ADD /ALT n SIGN n MOVE I I DEMOLISH REPAIR =►zoF PROPOSED USE X SFR ( 1 COMM I I OTHER I TYPE OF CONSTRUCTION Ix I BLOCK ( I FRAME I I STEEL I OTHER 1 DESCRIPTION OF WORK h ei r Cg . r k- r o c: 5 F R 3 w 1 4\ v r1 ('t: J f Qil S /� BUILDING SIZE I SQ FOOTAGE I J G OO HEIGHT I BUILDING ($ f79 00 ., s-- VALUATION OF TOTAL CONSTRUCTION I 1 ELECTRICAL $ [ AMP SERVICE I I PROGRESS ENERGY I I W.R.E.C. I 1 PLUMBING $ I I MECHANICAL $ I VALUATION OF MECHANICAL INSTALLATION I I GAS KI ROOFING I 1 SPECIALTY I 1 OTHER - FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA I IYES 1 • INO • BUILDER COMPANY 1 SIGNATURE REGISTERED I Y/ N J FEE CURRENT 1 Y/ N 1 Address ( I License # I ELECTRICIAN COMPANY 1 SIGNATURE REGISTERED I Y / N J FEE CURRENT I Y/ N I Address I 1 - License # I PLUMBER COMPANY I SIGNATURE REGISTERED I Y/ N _I FEE CURRENT I Y/ N I Address I 1 License # I MECHANICAL COMPANY I , SIGNATURE REGISTERED I Y/ N _I FEE CURRENT I Y/ N i Address I 1 1 License # I '` OT 111111116, ` I *1 - . COMPANY 1 f \' mO ► ` 01 r\ t 4In SIGNATU' 1 1� � �` _4` _ REGISTERED 1 T/ N j FEE CURRENT I N I Address co 3 -4i 5 - '_" _ 14 tiIS ;. C(I License# ICCL-( - S S 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 alter submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Sill 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: I Fill out application completely. Owner & Contractor sign back of application. notarized If over $2500, a Notice of Commencement is required. (NC upgrades over $5000) ** Agent (for the contractor) or Power of Attorney (for the owner) would be sorry one 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