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813 - 780 -0020 Lity of Lepnyrnitls Hermit Application ft ) Lf i O rax- oio- i ou - vuc.i Building Department 'T` on D:up c Gi Date Received " i3 ?_E _ R�j� '06e4-11— Phone Contact for Permittln Owner's Name Sc ( A d).e / Z Owner Phone Number , 3 - TAT / 3 Owner's Address 6 �� Jo D17 L.c►h- - oi✓L Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address • JOB ADDRESS (A f i4 - ,1 21. LR ka_ d4. 2.-e" /2/+ /5 rc 3 3 5 y 2_ LOT # Cos - SUBDIVISION SreP{.eniS C71qa; nT �p w-e.. PARCEL ID# 03 -26 L/ - 0/80 -- 00000 - O O (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I SIGN 1 1 MOVE Q DEMOLISH INSTALL REPAIR PROPOSED USE 1 1 SFR 1 1 COMM I I OTHER I TYPE OF CONSTRUCTION 1 1 BLOCK I I FRAME I STEEL ( OTHER 1 DESCRIPTION OF WORK r 1 p � 3; 5��or/ ! SS- -,2 guz� L0 •, T^ ( P/C Pock s S r E {U��S BUILDING SIZE - SQ FOOTAGE HEIGHT BUILDING $ VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY n W.R.E.C. I PLUMBING $ CD ` I MECHANICAL .' : VALUATION OF MECHANICAL INSTALLATION GAS 1 1 ROOFING SPECIALTY I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 !YES nNO • BUILDER COMPANY SIGNATURE REGISTERED I CO N I FEE CURRENT I Y! N Address P 1 License # I ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N f FEE CURRENT 1 Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # MECHANICAJ65/1-A--e•--- � c\ ^�,i eft---4-"e,---' COMPANY R( rte- �C kc f-1RRald 3 MyeRS SIGNATURE �/ ' / REGISTERED I Y / N j FEE CURR 1 Y / N 1 Address J Cf 2g inietCX J /uSlTf} sr FL- 3.5/7 License# 6.1 O5(0 5< OTHER SIGNATURE COMPANY REGISTERED I Y/ N I FEE CURRENT I Y/ N I • Address License # 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 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 commerclal requirements must meet compllance 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 A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter If on public roadways..needs ROW